ELISABETH LOGAN STARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

Title

First Name

ELISABETH

Middle

LOGAN

Last Name

STARK

Business Name

ELISABETH LOGAN STARK MD

Original Issue Date

07/19/2024

Effective Date

07/19/2024

Expiration Date

07/31/2026

City

NEW HAVEN

State

Zip

06511

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2024