STACEY MARIE SUDHOLT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

ACTIVE

Business

Title

First Name

STACEY

Middle

MARIE

Last Name

SUDHOLT

Business Name

STACEY MARIE SUDHOLT MD

Original Issue Date

04/17/2019

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/18/2023