PATRICE L STATEN 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

First Name

PATRICE

Middle

Last Name

STATEN

Suffix

Business Name

PATRICE L STATEN MD

Original Issue Date

05/13/2002

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023