STACEY ANN APPENHEIMER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

Title

First Name

STACEY

Middle

ANN

Last Name

APPENHEIMER

Business Name

STACEY ANN APPENHEIMER MD

Original Issue Date

05/08/2013

Effective Date

05/08/2013

Expiration Date

07/31/2014

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014