JOHN M COSTELLO - Medical Doctor License in Illinois | # 125032816

JOHN M COSTELLO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032816

License Status

EXPIRED

Business

N

First Name

JOHN

Middle

M

Last Name

COSTELLO

Business Name

JOHN M COSTELLO

Original Issue Date

05/30/1995

Effective Date

05/30/1995

Expiration Date

06/18/1998

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

09/22/2006