STACIE LYNN SHEPHERD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

Title

First Name

STACIE

Middle

LYNN

Last Name

SHEPHERD

Business Name

STACIE LYNN SHEPHERD MD

Original Issue Date

06/13/2008

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

REDWOOD CITY

State

Zip

94062

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023