STACEY E HORSTMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

STACEY

Middle

Last Name

HORSTMAN

Suffix

Business Name

STACEY E HORSTMAN MD

Original Issue Date

07/24/2003

Effective Date

07/17/2008

Expiration Date

07/31/2011

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020