ARIEL GALLANOSA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078977

License Status

CANCELLED

Business

Title

First Name

ARIEL

Last Name

GALLANOSA

Business Name

ARIEL GALLANOSA DO

Original Issue Date

06/26/2021

Effective Date

06/26/2021

Expiration Date

06/25/2024

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

05/26/2021