STEPHANIE RAE DEJONG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

RAE

Last Name

DEJONG

Business Name

STEPHANIE RAE DEJONG MD

Original Issue Date

05/14/2021

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023