ANDRE JAWANN SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

First Name

ANDRE

Middle

JAWANN

Last Name

SULLIVAN

Suffix

Business Name

ANDRE JAWANN SULLIVAN MD

Original Issue Date

07/28/2025

Effective Date

07/28/2025

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/28/2025