STACY A HARRIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

STACY A

Last Name

HARRIS

Suffix

Business Name

STACY A HARRIS MD

Original Issue Date

07/02/1996

Effective Date

07/02/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006