MIRIAM JILL SULLIVAN MD SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042620349

License Status

NOT RENEWED

Business

Business Name

MIRIAM JILL SULLIVAN MD SC

Original Issue Date

09/02/2014

Effective Date

11/10/2015

Expiration Date

01/01/2017

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/10/2017