KIM M SULLIVAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

CANCELLED

Business

First Name

KIM

Middle

Last Name

SULLIVAN

Suffix

Business Name

KIM M SULLIVAN MD

Original Issue Date

11/20/2000

Effective Date

11/20/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006