TOM DAVIS STANLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

TOM

Middle

DAVIS

Last Name

STANLEY

Suffix

Business Name

TOM DAVIS STANLEY MD

Original Issue Date

05/06/2010

Effective Date

04/15/2014

Expiration Date

07/31/2017

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020