JACINTA IRENE GILLIS 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

First Name

JACINTA

Middle

IRENE

Last Name

GILLIS

Suffix

Business Name

JACINTA IRENE GILLIS MD

Original Issue Date

03/08/2005

Effective Date

03/08/2005

Expiration Date

07/31/2008

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008