GREGORY M ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

Last Name

ANDERSON

Suffix

Business Name

GREGORY M ANDERSON MD

Original Issue Date

01/04/2007

Effective Date

08/12/2008

Expiration Date

07/31/2011

City

HIGHLAND

State

Zip

62249

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011