ANDREAS HANS GOMOLL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

ANDREAS

Middle

HANS

Last Name

GOMOLL

Suffix

Business Name

ANDREAS HANS GOMOLL MD

Original Issue Date

04/28/2005

Effective Date

04/28/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008