G W STEVENSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057276

License Status

NOT RENEWED

Business

First Name

Middle

Last Name

STEVENSON

Suffix

Business Name

G W STEVENSON MD

Original Issue Date

07/24/1978

Effective Date

04/25/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017