STACY ANASTASIA GORDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

STACY ANASTASIA

Last Name

GORDON

Suffix

Business Name

STACY ANASTASIA GORDON MD

Original Issue Date

07/23/1986

Effective Date

07/23/1986

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006