STEPHANIE SHORT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078564

License Status

EXPIRED

Business

Title

First Name

STEPHANIE

Last Name

SHORT

Business Name

STEPHANIE SHORT MD

Original Issue Date

06/26/2021

Effective Date

06/26/2021

Expiration Date

06/25/2024

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/30/2024