KATHERINE WAILEN SU Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

First Name

KATHERINE

Middle

WAILEN

Last Name

Business Name

KATHERINE WAILEN SU

Original Issue Date

05/12/2021

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023