STEFAN G VANDERWEIL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

STEFAN

Middle

Last Name

VANDERWEIL

Business Name

STEFAN G VANDERWEIL MD

Original Issue Date

03/25/2016

Effective Date

05/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

MASSACHUSETTS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021