STEWART OWEN PINE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

Title

First Name

STEWART

Middle

OWEN

Last Name

PINE

Business Name

STEWART OWEN PINE MD

Original Issue Date

10/20/2023

Effective Date

10/20/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2024