STEPHANIE L SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139496

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

Last Name

SULLIVAN

Prefix

Business Name

STEPHANIE L SULLIVAN MD

Original Issue Date

12/16/2015

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

EDWARDS

State

Zip

61528

County

WILL

Ever Disciplined

LastModifiedDate

07/14/2023