RANDALL G SULLIVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

RANDALL G

Last Name

SULLIVAN

Suffix

Business Name

RANDALL G SULLIVAN MD

Original Issue Date

11/01/1984

Effective Date

11/01/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006