MICHAEL JAMES COSTELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

JAMES

Last Name

COSTELLO

Business Name

MICHAEL JAMES COSTELLO MD

Original Issue Date

11/20/2015

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

PORT ST LUCIE

State

Zip

34986

County

FLORIDA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021