AMANDA PORTER DAUTEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

AMANDA

Middle

PORTER

Last Name

DAUTEN

Business Name

AMANDA PORTER DAUTEN MD

Original Issue Date

02/22/2021

Effective Date

07/16/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/16/2023