AMY KRISTEN WHITAKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

AMY

Middle

KRISTEN

Last Name

WHITAKER

Suffix

Business Name

AMY KRISTEN WHITAKER MD

Original Issue Date

05/17/2022

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023