GREGORY LOUIS JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

LOUIS

Last Name

JOHNSON

Suffix

Business Name

GREGORY LOUIS JOHNSON MD

Original Issue Date

05/03/2006

Effective Date

09/25/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61602

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021