JOHN BRADLEY STARK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

CANCELLED

Business

First Name

JOHN

Middle

BRADLEY

Last Name

STARK

Suffix

Business Name

JOHN BRADLEY STARK MD

Original Issue Date

11/15/2004

Effective Date

11/15/2004

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008