KENNETH P SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

First Name

KENNETH P

Last Name

SULLIVAN

Suffix

Business Name

KENNETH P SULLIVAN MD

Original Issue Date

01/01/1997

Effective Date

05/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60601

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2023