JONAS M SULLIVAN Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

CANCELLED

Business

First Name

JONAS

Middle

Last Name

SULLIVAN

Business Name

JONAS M SULLIVAN

Original Issue Date

06/21/2004

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011