KRISTINE MELBY MCCULLOCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

KRISTINE MELBY

Last Name

MCCULLOCH

Suffix

Business Name

KRISTINE MELBY MCCULLOCH MD

Original Issue Date

01/01/1997

Effective Date

07/01/2011

Expiration Date

07/31/2014

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014