JACOB A STELLE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058463

License Status

CANCELLED

Business

Title

First Name

JACOB

Middle

Last Name

STELLE

Business Name

JACOB A STELLE MD

Original Issue Date

06/26/2013

Effective Date

06/26/2013

Expiration Date

06/25/2015

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

03/24/2014