STACEE MARIE LEWIS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072646

License Status

CANCELLED

Business

Title

First Name

STACEE

Middle

MARIE

Last Name

LEWIS

Business Name

STACEE MARIE LEWIS MD

Original Issue Date

06/25/2018

Effective Date

06/25/2018

Expiration Date

06/24/2021

City

CHICAGO

State

Zip

60605

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

05/07/2018