EUGENE A GONZALES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

EUGENE A

Last Name

GONZALES

Suffix

Business Name

EUGENE A GONZALES MD

Original Issue Date

12/06/1996

Effective Date

12/06/1996

Expiration Date

07/31/1999

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006