ANNETTE Z STORMONT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

ANNETTE Z

Last Name

STORMONT

Suffix

Business Name

ANNETTE Z STORMONT MD

Original Issue Date

05/29/1996

Effective Date

05/29/1996

Expiration Date

07/31/2002

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006