GREGORY THOMAS GILLES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

GREGORY

Middle

THOMAS

Last Name

GILLES

Business Name

GREGORY THOMAS GILLES MD

Original Issue Date

06/12/2019

Effective Date

06/12/2019

Expiration Date

09/30/2020

City

WAUSAU

State

Zip

54403

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021