STEPHANIE E HEAVEY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

HEAVEY

Business Name

STEPHANIE E HEAVEY

Original Issue Date

06/03/2004

Effective Date

07/23/2008

Expiration Date

07/31/2011

City

HINSDALE

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011