GLEN RICHARD COULOMB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

GLEN RICHARD

Last Name

COULOMB

Suffix

Business Name

GLEN RICHARD COULOMB MD

Original Issue Date

05/02/1995

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

LISLE

State

Zip

60532

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/27/2023