GEORGE C GUSTAFSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

GEORGE

Middle

Last Name

GUSTAFSON

Suffix

Business Name

GEORGE C GUSTAFSON MD

Original Issue Date

06/12/2000

Effective Date

06/12/2000

Expiration Date

07/31/2002

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011