KIMBERLY ANN STANFORD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

KIMBERLY

Middle

ANN

Last Name

STANFORD

Business Name

KIMBERLY ANN STANFORD MD

Original Issue Date

06/14/2017

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023