ROBERT MICHAEL SCULLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

ROBERT MICHAEL

Last Name

SCULLY

Suffix

Business Name

ROBERT MICHAEL SCULLY MD

Original Issue Date

01/01/1997

Effective Date

07/25/2011

Expiration Date

07/31/2014

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014