STEPHANIE ANN VAN ULFT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

ANN

Last Name

VAN ULFT

Suffix

Business Name

STEPHANIE ANN VAN ULFT MD

Original Issue Date

08/22/2000

Effective Date

08/22/2000

Expiration Date

07/31/2005

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020