STACEY ELEAN OCCOMY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

ELEAN

Last Name

OCCOMY

Suffix

Business Name

STACEY ELEAN OCCOMY MD

Original Issue Date

01/11/2002

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021