GLEN RICHARD COULOMB MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

GLEN RICHARD

Last Name

COULOMB

Suffix

Business Name

GLEN RICHARD COULOMB MD

Original Issue Date

12/24/1981

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

NAPERVILLE

State

Zip

60540

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021