GARY EUGENE STANFORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057916

License Status

NOT RENEWED

Business

First Name

GARY EUGENE

Last Name

STANFORD

Suffix

Business Name

GARY EUGENE STANFORD MD

Original Issue Date

10/23/1978

Effective Date

10/23/1978

Expiration Date

07/31/1987

City

NEWARK

State

Zip

60541

County

KENDALL

Ever Disciplined

LastModifiedDate

03/24/2007

Case Number

1985000587

Action

Suspension

Discipline Start Date

08/19/1986