AMANDA RENEE WIGGINS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

ACTIVE

Business

Title

First Name

AMANDA

Middle

RENEE

Last Name

WIGGINS

Business Name

AMANDA RENEE WIGGINS MD

Original Issue Date

04/24/2024

Effective Date

04/24/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/24/2024