SAMANTHA JO STIFF MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070548

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

Last Name

STIFF

Business Name

SAMANTHA JO STIFF MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

11/19/2020