EDWARD J STANFORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

Last Name

STANFORD

Suffix

Business Name

EDWARD J STANFORD MD

Original Issue Date

06/15/2007

Effective Date

06/15/2007

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011