DIANA CAROL MCNULTY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

ACTIVE

Business

First Name

DIANA

Middle

CAROL

Last Name

MCNULTY

Suffix

Business Name

DIANA CAROL MCNULTY MD

Original Issue Date

02/23/2001

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023