KRISTINE MELBY MCCULLOCH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054332

License Status

INACTIVE

Business

First Name

KRISTINE MELBY

Last Name

MCCULLOCH

Suffix

Business Name

KRISTINE MELBY MCCULLOCH MD

Original Issue Date

03/14/1977

Effective Date

07/01/2011

Expiration Date

07/31/2014

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014