DOUGLAS M STEVENS 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

DOUGLAS M

Last Name

STEVENS

Business Name

DOUGLAS M STEVENS

Original Issue Date

01/31/1996

Effective Date

01/31/1996

Expiration Date

07/31/1999

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006