LISA M SULLIVAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042080

License Status

EXPIRED

Business

Title

First Name

LISA

Middle

Last Name

SULLIVAN

Business Name

LISA M SULLIVAN MD

Original Issue Date

07/21/2000

Effective Date

07/21/2000

Expiration Date

07/20/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006