GAYL M GLOWACKI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000362

License Status

EXPIRED

Business

First Name

GAYL

Middle

Last Name

GLOWACKI

Business Name

GAYL M GLOWACKI

Original Issue Date

04/22/1997

Effective Date

04/22/1997

Expiration Date

09/20/1997

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006