MARY LOUISE GANNON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

MARY

Middle

LOUISE

Last Name

GANNON

Suffix

Business Name

MARY LOUISE GANNON MD

Original Issue Date

09/14/1988

Effective Date

07/05/2017

Expiration Date

09/30/2020

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021