RONALD FREDERICK STAVINGA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046046

License Status

INACTIVE

Business

First Name

RONALD FREDERICK

Last Name

STAVINGA

Suffix

Business Name

RONALD FREDERICK STAVINGA MD

Original Issue Date

08/17/1972

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

HINSDALE

State

Zip

60521

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/05/2020