MICHAEL WILLIAM SULLIVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

WILLIAM

Last Name

SULLIVAN

Suffix

Business Name

MICHAEL WILLIAM SULLIVAN MD

Original Issue Date

07/22/1998

Effective Date

07/22/1998

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011