CARYN M STACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

CARYN M

Last Name

STACK

Suffix

Business Name

CARYN M STACK MD

Original Issue Date

09/10/1990

Effective Date

05/10/2011

Expiration Date

07/31/2014

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014