AMANDA STOVALL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

Title

First Name

AMANDA

Last Name

STOVALL

Business Name

AMANDA STOVALL MD

Original Issue Date

07/31/2021

Effective Date

04/18/2023

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

04/18/2023