JOHN M COSTELLO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

JOHN

Middle

Last Name

COSTELLO

Business Name

JOHN M COSTELLO

Original Issue Date

07/07/1997

Effective Date

05/10/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021