TODD W STULL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

TODD W

Last Name

STULL

Suffix

Business Name

TODD W STULL MD

Original Issue Date

06/20/1996

Effective Date

06/20/1996

Expiration Date

07/31/1999

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020