DONNIE RAY STACY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

DONNIE

Middle

RAY

Last Name

STACY

Suffix

Business Name

DONNIE RAY STACY MD

Original Issue Date

04/13/2004

Effective Date

06/07/2011

Expiration Date

07/31/2014

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014