MICHELLE L SULLIVAN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

First Name

MICHELLE L

Last Name

SULLIVAN

Business Name

MICHELLE L SULLIVAN

Original Issue Date

09/22/1995

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

MOKENA

State

Zip

60448

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023