STEPHANIE NICOLE BUCKLEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062187

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

NICOLE

Last Name

BUCKLEY

Business Name

STEPHANIE NICOLE BUCKLEY MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014