ALEXANDRA GYBBON FALLON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

ALEXANDRA

Middle

GYBBON

Last Name

FALLON

Business Name

ALEXANDRA GYBBON FALLON MD

Original Issue Date

12/30/2022

Effective Date

04/16/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2023