TYLER GILBERT GUNDERSON 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

TYLER

Middle

GILBERT

Last Name

GUNDERSON

Suffix

Business Name

TYLER GILBERT GUNDERSON MD

Original Issue Date

04/12/2007

Effective Date

05/15/2017

Expiration Date

09/30/2020

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021