DAVID M SULLIVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

DAVID M

Last Name

SULLIVAN

Suffix

Business Name

DAVID M SULLIVAN MD

Original Issue Date

07/17/1990

Effective Date

07/17/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006