STEPHANIE MARIE KANITSCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

MARIE

Last Name

KANITSCH

Business Name

STEPHANIE MARIE KANITSCH MD

Original Issue Date

07/24/2018

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023