ERIC SULLIVAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075200

License Status

CANCELLED

Business

Title

First Name

ERIC

Last Name

SULLIVAN

Business Name

ERIC SULLIVAN MD

Original Issue Date

06/23/2019

Effective Date

06/23/2019

Expiration Date

06/22/2022

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/17/2019