KRISTEN J SCULLY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056239

License Status

EXPIRED

Business

Title

First Name

KRISTEN

Middle

Last Name

SCULLY

Business Name

KRISTEN J SCULLY MD

Original Issue Date

06/23/2009

Effective Date

06/23/2009

Expiration Date

06/22/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/29/2012