STEPHANIE L ANDERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106405

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

ANDERSON

Business Name

STEPHANIE L ANDERSON

Original Issue Date

03/01/2002

Effective Date

03/01/2002

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006