PHILLIP MICHAEL STANDEN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070781

License Status

EXPIRED

Business

Title

First Name

PHILLIP

Middle

MICHAEL

Last Name

STANDEN

Business Name

PHILLIP MICHAEL STANDEN DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

11/19/2020