STEPHANIE ELIZABETH PLACE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058235

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

ELIZABETH

Last Name

PLACE

Business Name

STEPHANIE ELIZABETH PLACE MD

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

06/22/2013

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/21/2010