STEPHANIE ANN GORHAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051162

License Status

EXPIRED

Business

First Name

STEPHANIE

Middle

ANN

Last Name

GORHAM

Suffix

Business Name

STEPHANIE ANN GORHAM MD

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

BELVIDERE

State

Zip

61008

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/15/2009