MATTHEW DAVID GILLEN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070484

License Status

EXPIRED

Business

Title

First Name

MATTHEW

Middle

DAVID

Last Name

GILLEN

Business Name

MATTHEW DAVID GILLEN DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/19/2020