SUSANNE GONZALEZ GALLARDO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

Title

First Name

SUSANNE

Middle

GONZALEZ

Last Name

GALLARDO

Business Name

SUSANNE GONZALEZ GALLARDO MD

Original Issue Date

06/03/2013

Effective Date

04/14/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017