LENA ROSE WILEY 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

LENA

Middle

ROSE

Last Name

WILEY

Business Name

LENA ROSE WILEY MD

Original Issue Date

04/10/2023

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023