MATTHEW A GULLICKSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107303

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

Last Name

GULLICKSON

Business Name

MATTHEW A GULLICKSON

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

07/31/2005

City

VILLA PARK

State

Zip

60181

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2006