STEPHANIE L SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

Last Name

SULLIVAN

Prefix

Business Name

STEPHANIE L SULLIVAN MD

Original Issue Date

12/16/2015

Effective Date

07/14/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/14/2023