STACY A MCCONKEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

CANCELLED

Business

First Name

STACY A

Last Name

MCCONKEY

Suffix

Business Name

STACY A MCCONKEY MD

Original Issue Date

03/24/1997

Effective Date

03/24/1997

Expiration Date

07/31/2002

City

GENESEO

State

Zip

61254

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006