JACLYN PAIGE WINIKOFF WALLIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

Title

First Name

JACLYN

Middle

PAIGE

Last Name

WINIKOFF WALLIS

Business Name

JACLYN PAIGE WINIKOFF WALLIS MD

Original Issue Date

11/20/2018

Effective Date

05/05/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023