GARY D GONSALVES MD 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

GARY

Middle

Last Name

GONSALVES

Suffix

Business Name

GARY D GONSALVES MD

Original Issue Date

05/04/2005

Effective Date

05/04/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008