STEPHEN WAYNE DAUGHERTY DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

Title

DPM

First Name

STEPHEN

Middle

WAYNE

Last Name

DAUGHERTY

Business Name

STEPHEN WAYNE DAUGHERTY DPM

Original Issue Date

08/22/2018

Effective Date

01/14/2019

Expiration Date

01/31/2021

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021