MARY SUZANNE STEVENS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

MARY

Middle

SUZANNE

Last Name

STEVENS

Business Name

MARY SUZANNE STEVENS

Original Issue Date

07/23/1999

Effective Date

07/23/1999

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006