BAILEY ANN WENTWORTH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

Title

First Name

BAILEY

Middle

ANN

Last Name

WENTWORTH

Business Name

BAILEY ANN WENTWORTH MD

Original Issue Date

04/08/2021

Effective Date

04/10/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/10/2023