CORNELL MCCULLOM III DDS MD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

ACTIVE

Business

First Name

CORNELL

Last Name

MCCULLOM III

Suffix

DDS MD

Business Name

CORNELL MCCULLOM III DDS MD

Original Issue Date

08/09/1988

Effective Date

09/18/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60619

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2024