STACEY ANN APPENHEIMER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132801

License Status

NOT RENEWED

Business

Title

First Name

STACEY

Middle

ANN

Last Name

APPENHEIMER

Business Name

STACEY ANN APPENHEIMER MD

Original Issue Date

05/08/2013

Effective Date

05/08/2013

Expiration Date

07/31/2014

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

11/17/2014