CAROLYN B COULAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

CAROLYN B

Last Name

COULAM

Suffix

Business Name

CAROLYN B COULAM MD

Original Issue Date

05/08/1996

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021