MARA B STEPHENSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061963

License Status

CANCELLED

Business

Title

First Name

MARA

Middle

Last Name

STEPHENSON

Business Name

MARA B STEPHENSON DO

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/24/2014