STEPHANIE ANN GORHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

ACTIVE

Business

First Name

STEPHANIE

Middle

ANN

Last Name

GORHAM

Suffix

Business Name

STEPHANIE ANN GORHAM MD

Original Issue Date

05/21/2009

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

BELVIDERE

State

Zip

61008

County

BOONE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023