STACEY MARIE SUDHOLT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067108

License Status

CANCELLED

Business

Title

First Name

STACEY

Middle

MARIE

Last Name

SUDHOLT

Business Name

STACEY MARIE SUDHOLT MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

06/01/2015