STEPHANIE L SULLIVAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063484

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

Last Name

SULLIVAN

Prefix

Business Name

STEPHANIE L SULLIVAN MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/24/2014