TROND ALVAR STOCKENSTROM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

TROND

Middle

ALVAR

Last Name

STOCKENSTROM

Suffix

Business Name

TROND ALVAR STOCKENSTROM MD

Original Issue Date

07/10/2000

Effective Date

07/10/2000

Expiration Date

07/31/2002

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006