GAINES WARDLAW HAMMOND MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

Title

First Name

GAINES

Middle

WARDLAW

Last Name

HAMMOND

Business Name

GAINES WARDLAW HAMMOND MD

Original Issue Date

07/29/2020

Effective Date

07/29/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023