MARY COLLEEN COSTELLO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036118823

License Status

NOT RENEWED

Business

First Name

MARY

Middle

COLLEEN

Last Name

COSTELLO

Suffix

Business Name

MARY COLLEEN COSTELLO MD

Original Issue Date

06/27/2007

Effective Date

05/23/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011