STEPHANIE A DETTERLINE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113740

License Status

INACTIVE

Business

First Name

STEPHANIE

Middle

Last Name

DETTERLINE

Suffix

Business Name

STEPHANIE A DETTERLINE MD

Original Issue Date

05/20/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CINCINNATI

State

Zip

45208

County

HAMILTON

Ever Disciplined

LastModifiedDate

04/17/2008