JENNAH SIWAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

Title

First Name

JENNAH

Last Name

SIWAK

Business Name

JENNAH SIWAK MD

Original Issue Date

06/05/2018

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

METAMORA

State

Zip

61548

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023