DALIA JEANETTE WENCKUS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

DALIA

Middle

JEANETTE

Last Name

WENCKUS

Suffix

Business Name

DALIA JEANETTE WENCKUS MD

Original Issue Date

06/11/2010

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

BELLBROOK

State

Zip

45305

County

OHIO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020