CODY WAYNE SULLIVAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036165650

License Status

ACTIVE

Business

Title

First Name

CODY

Middle

WAYNE

Last Name

SULLIVAN

Business Name

CODY WAYNE SULLIVAN MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

07/31/2026

City

PADUCAH

State

Zip

42003

Ever Disciplined

LastModifiedDate

07/01/2023