DAVID J STEPHEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

Title

First Name

DAVID

Middle

Last Name

STEPHEN

Business Name

DAVID J STEPHEN DO

Original Issue Date

09/12/2017

Effective Date

09/12/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60617

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021