MARY LOUISE GANNON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068239

License Status

NOT RENEWED

Business

First Name

MARY

Middle

LOUISE

Last Name

GANNON

Suffix

Business Name

MARY LOUISE GANNON MD

Original Issue Date

02/01/1984

Effective Date

07/05/2017

Expiration Date

09/30/2020

City

ELMHURST

State

Zip

60126

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/14/2021