DONALD EDWARD GIBBONS III Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

EDWARD

Last Name

GIBBONS

Suffix

III

Business Name

DONALD EDWARD GIBBONS III

Original Issue Date

05/18/2006

Effective Date

05/18/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008