KEVIN LEO SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

ACTIVE

Business

First Name

KEVIN LEO

Last Name

SULLIVAN

Suffix

Business Name

KEVIN LEO SULLIVAN MD

Original Issue Date

03/28/1986

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

NILES

State

Zip

60714

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023