LORI DOCKSTADER RACSA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138779

License Status

ACTIVE

Business

Title

First Name

LORI

Middle

DOCKSTADER

Last Name

RACSA

Business Name

LORI DOCKSTADER RACSA DO

Original Issue Date

07/24/2015

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

04/29/2023