JONATHON WILLIAM WANTA 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

JONATHON

Middle

WILLIAM

Last Name

WANTA

Business Name

JONATHON WILLIAM WANTA MD

Original Issue Date

04/08/2022

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023