JENNIFER ELLEN STEVENS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

ELLEN

Last Name

STEVENS

Business Name

JENNIFER ELLEN STEVENS MD

Original Issue Date

07/13/2009

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

FAIRBURY

State

Zip

61739

County

LIVINGSTON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021