HEATHER HELENE COSTELLO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

HEATHER

Middle

HELENE

Last Name

COSTELLO

Suffix

Business Name

HEATHER HELENE COSTELLO MD

Original Issue Date

01/10/2022

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60654

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

06/15/2023