QUALLS E STEVENS DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044964

License Status

EXPIRED

Business

First Name

QUALLS

Middle

Last Name

STEVENS

Suffix

Business Name

QUALLS E STEVENS DO

Original Issue Date

06/19/2002

Effective Date

06/19/2002

Expiration Date

06/30/2008

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

07/31/2008