STANFORD MARK MORAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

STANFORD MARK

Last Name

MORAN

Suffix

Business Name

STANFORD MARK MORAN MD

Original Issue Date

10/14/1987

Effective Date

10/14/1987

Expiration Date

07/31/1993

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017