JACK MICHAEL GIBSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064619

License Status

ACTIVE

Business

First Name

JACK MICHAEL

Last Name

GIBSON

Suffix

Business Name

JACK MICHAEL GIBSON MD

Original Issue Date

06/28/1982

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

04/15/2023