AUDRA JOY STORM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

Title

First Name

AUDRA

Middle

JOY

Last Name

STORM

Business Name

AUDRA JOY STORM MD

Original Issue Date

08/20/2024

Effective Date

08/20/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/20/2024