SULLIVAN MCINTOSH SMITH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074394

License Status

EXPIRED

Business

Title

First Name

SULLIVAN

Middle

MCINTOSH

Last Name

SMITH

Business Name

SULLIVAN MCINTOSH SMITH MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2024

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

10/30/2024