DAVID RYAN SULLIVAN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

RYAN

Last Name

SULLIVAN

Suffix

DPM

Business Name

DAVID RYAN SULLIVAN DPM

Original Issue Date

03/01/2001

Effective Date

11/21/2006

Expiration Date

01/31/2009

City

CARBONDALE

State

Zip

62903

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/17/2009