STACIE RENEE GREGORY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059775

License Status

EXPIRED

Business

Title

First Name

STACIE

Middle

RENEE

Last Name

GREGORY

Business Name

STACIE RENEE GREGORY MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

06/25/2016

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

08/16/2016