GARY JACK DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

Title

First Name

GARY

Middle

JACK

Last Name

DAVIS

Business Name

GARY JACK DAVIS MD

Original Issue Date

05/05/1982

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021