MARIA AGNES STANLEY Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

First Name

MARIA

Middle

AGNES

Last Name

STANLEY

Business Name

MARIA AGNES STANLEY

Original Issue Date

03/05/2021

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

MADISON

State

Zip

53705

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023