KENNETH P SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058001

License Status

ACTIVE

Business

First Name

KENNETH P

Last Name

SULLIVAN

Suffix

Business Name

KENNETH P SULLIVAN MD

Original Issue Date

10/23/1978

Effective Date

04/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

04/18/2023