STEPHANIE NICOLE LORTS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000648

License Status

CANCELLED

Business

Title

First Name

STEPHANIE

Middle

NICOLE

Last Name

LORTS

Business Name

STEPHANIE NICOLE LORTS MD

Original Issue Date

02/01/2018

Effective Date

02/01/2018

Expiration Date

07/31/2018

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

01/16/2018