JAMES PHILIP SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

JAMES

Middle

PHILIP

Last Name

SULLIVAN

Business Name

JAMES PHILIP SULLIVAN MD

Original Issue Date

01/25/2024

Effective Date

01/25/2024

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/19/2023