WAYNE KENNETH MANNESS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

First Name

WAYNE

Middle

KENNETH

Last Name

MANNESS

Suffix

Business Name

WAYNE KENNETH MANNESS MD

Original Issue Date

07/15/1999

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/13/2024