STEPHANIE J KIELB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

KIELB

Suffix

Business Name

STEPHANIE J KIELB MD

Original Issue Date

09/04/2002

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020