JENNIFER A WAMBACH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

JENNIFER

Middle

Last Name

WAMBACH

Business Name

JENNIFER A WAMBACH MD

Original Issue Date

01/23/2004

Effective Date

12/03/2024

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2024