MARK T GIBSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

ACTIVE

Business

First Name

MARK T

Last Name

GIBSON

Suffix

Business Name

MARK T GIBSON MD

Original Issue Date

12/16/1996

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

MORRIS

State

Zip

60450

County

GRUNDY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023