GARY TODD GILLHAM DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

INACTIVE

Business

First Name

GARY

Middle

TODD

Last Name

GILLHAM

Suffix

Business Name

GARY TODD GILLHAM DO

Original Issue Date

02/16/2011

Effective Date

07/21/2011

Expiration Date

07/31/2014

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017