NICHOLAS K SULLIVAN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

NICHOLAS

Middle

Last Name

SULLIVAN

Business Name

NICHOLAS K SULLIVAN DO

Original Issue Date

07/08/2016

Effective Date

07/08/2016

Expiration Date

07/31/2017

City

DUBUQUE

State

Zip

52003

County

IOWA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

11/01/2017