STEPHANIE LYNN JOHNSON DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062740

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

LYNN

Last Name

JOHNSON

Business Name

STEPHANIE LYNN JOHNSON DO

Original Issue Date

06/07/2013

Effective Date

06/07/2013

Expiration Date

06/30/2016

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014