STEPHANIE L ANDERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

ANDERSON

Business Name

STEPHANIE L ANDERSON

Original Issue Date

05/07/2002

Effective Date

05/07/2002

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006