DAVID STANLEY DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

STANLEY

Last Name

DAVIS

Suffix

Business Name

DAVID STANLEY DAVIS MD

Original Issue Date

12/16/2002

Effective Date

12/16/2002

Expiration Date

07/31/2005

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011