STANTON FORREST DODSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

STANTON

Middle

FORREST

Last Name

DODSON

Suffix

Business Name

STANTON FORREST DODSON MD

Original Issue Date

08/13/2002

Effective Date

08/09/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014