MATTHEW THOMAS STANDRIDGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

THOMAS

Last Name

STANDRIDGE

Suffix

Business Name

MATTHEW THOMAS STANDRIDGE MD

Original Issue Date

06/09/2010

Effective Date

06/09/2010

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60623

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/10/2011