BENJAMIN THOMAS STEVENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

BENJAMIN

Middle

THOMAS

Last Name

STEVENS

Suffix

Business Name

BENJAMIN THOMAS STEVENS MD

Original Issue Date

08/21/2000

Effective Date

08/21/2000

Expiration Date

07/31/2008

City

SILVIS

State

Zip

61282

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008