COLIN BERGEN MCCULLOCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

Title

First Name

COLIN

Middle

BERGEN

Last Name

MCCULLOCH

Business Name

COLIN BERGEN MCCULLOCH MD

Original Issue Date

12/27/2022

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023