MICHAEL J SULLIVAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000766

License Status

NOT RENEWED

Business

First Name

MICHAEL J

Last Name

SULLIVAN

Business Name

MICHAEL J SULLIVAN

Original Issue Date

02/07/1996

Effective Date

02/07/1996

Expiration Date

03/01/1998

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006