MICHAEL ANDREW SULLIVAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002400

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ANDREW

Last Name

SULLIVAN

Business Name

MICHAEL ANDREW SULLIVAN

Original Issue Date

10/29/2004

Effective Date

10/29/2004

Expiration Date

03/01/2008

City

PEARLAND

State

Zip

77584

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008