CHARLES OTIS STANLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

CHARLES OTIS

Last Name

STANLEY

Suffix

Business Name

CHARLES OTIS STANLEY MD

Original Issue Date

01/01/1997

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

DECATUR

State

Zip

62521

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011