STEPHEN LEWIS GOLDMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

First Name

STEPHEN

Middle

LEWIS

Last Name

GOLDMAN

Suffix

Business Name

STEPHEN LEWIS GOLDMAN MD

Original Issue Date

08/07/2000

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61629

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014