COSTELLO CORNWALLIS STOKES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

COSTELLO

Middle

CORNWALLIS

Last Name

STOKES

Suffix

Business Name

COSTELLO CORNWALLIS STOKES MD

Original Issue Date

01/01/1997

Effective Date

07/07/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60620

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017