SULLY CARDONA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062062

License Status

CANCELLED

Business

Title

First Name

SULLY

Last Name

CARDONA

Business Name

SULLY CARDONA MD

Original Issue Date

06/23/2012

Effective Date

06/23/2012

Expiration Date

06/22/2015

City

CHICAGO

State

Zip

60641

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014