STEPHEN R ANDRESEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043729

License Status

NOT RENEWED

Business

First Name

STEPHEN R

Last Name

ANDRESEN

Suffix

Business Name

STEPHEN R ANDRESEN MD

Original Issue Date

09/24/1970

Effective Date

09/24/1970

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/09/2006