MICHAEL J GIBBONS 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

MICHAEL J

Last Name

GIBBONS

Suffix

Business Name

MICHAEL J GIBBONS MD

Original Issue Date

07/12/1995

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023