STEPHANIE LYNN JOHNSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036138822

License Status

NOT RENEWED

Business

Title

First Name

STEPHANIE

Middle

LYNN

Last Name

JOHNSON

Business Name

STEPHANIE LYNN JOHNSON DO

Original Issue Date

07/30/2015

Effective Date

07/30/2015

Expiration Date

07/31/2017

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

11/01/2017