CORNELL MCCULLOM III DDS MD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000232

License Status

ACTIVE

Business

First Name

CORNELL

Last Name

MCCULLOM III

Suffix

DDS MD

Business Name

CORNELL MCCULLOM III DDS MD

Original Issue Date

02/15/1990

Effective Date

09/18/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60619

County

COOK

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

09/18/2024