STEPHANIE MATHEWS KAZANTSEV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

MATHEWS

Last Name

KAZANTSEV

Business Name

STEPHANIE MATHEWS KAZANTSEV MD

Original Issue Date

02/20/2019

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

CREST HILL

State

Zip

60403

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023