STACY ANASTASIA GORDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072490

License Status

NOT RENEWED

Business

First Name

STACY ANASTASIA

Last Name

GORDON

Suffix

Business Name

STACY ANASTASIA GORDON MD

Original Issue Date

04/03/1986

Effective Date

04/03/1986

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006