MICHAEL BRODY O'SULLIVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

BRODY

Last Name

O'SULLIVAN

Business Name

MICHAEL BRODY O'SULLIVAN MD

Original Issue Date

03/20/2019

Effective Date

03/20/2019

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021