JULIE DONNELLY STARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121864

License Status

NOT RENEWED

Business

First Name

JULIE

Middle

DONNELLY

Last Name

STARK

Suffix

Business Name

JULIE DONNELLY STARK MD

Original Issue Date

08/27/2008

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

FORT WAYNE

State

Zip

46804

County

INDIANA

Ever Disciplined

LastModifiedDate

11/17/2014