DWIGHT DAVID STAPLETON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

DWIGHT

Middle

DAVID

Last Name

STAPLETON

Business Name

DWIGHT DAVID STAPLETON MD

Original Issue Date

07/26/2016

Effective Date

04/26/2017

Expiration Date

09/30/2020

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021