DAVID RYAN SULLIVAN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005002

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

RYAN

Last Name

SULLIVAN

Suffix

DPM

Business Name

DAVID RYAN SULLIVAN DPM

Original Issue Date

01/10/2001

Effective Date

02/01/2007

Expiration Date

01/31/2009

City

CARBONDALE

State

Zip

62903

County

JACKSON

Ever Disciplined

LastModifiedDate

03/17/2009