CORNELL MCCULLOM III DDS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032086

License Status

EXPIRED

Business

First Name

CORNELL

Last Name

MCCULLOM III

Suffix

DDS MD

Business Name

CORNELL MCCULLOM III DDS MD

Original Issue Date

06/30/1994

Effective Date

06/30/1994

Expiration Date

06/30/1997

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006