GARY MARK AMUNDSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

Title

First Name

GARY

Middle

MARK

Last Name

AMUNDSON

Business Name

GARY MARK AMUNDSON MD

Original Issue Date

06/27/2016

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021