MICHAEL WAYNE STEVENS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068180

License Status

EXPIRED

Business

Title

First Name

MICHAEL

Middle

WAYNE

Last Name

STEVENS

Business Name

MICHAEL WAYNE STEVENS MD

Original Issue Date

06/22/2019

Effective Date

06/22/2019

Expiration Date

06/21/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020