ROBERT MICHAEL SCULLY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054656

License Status

INACTIVE

Business

First Name

ROBERT MICHAEL

Last Name

SCULLY

Suffix

Business Name

ROBERT MICHAEL SCULLY MD

Original Issue Date

06/09/1977

Effective Date

07/25/2011

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/08/2014