FREDERICK L STEPHENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

Title

First Name

FREDERICK

Middle

Last Name

STEPHENS

Business Name

FREDERICK L STEPHENS MD

Original Issue Date

05/07/2018

Effective Date

05/07/2018

Expiration Date

09/30/2020

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021