CLEMENCE MARIE SULLIVAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058468

License Status

EXPIRED

Business

Title

First Name

CLEMENCE

Middle

MARIE

Last Name

SULLIVAN

Business Name

CLEMENCE MARIE SULLIVAN MD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

10/07/2013