GREGORY JOHN MALANOSKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

GREGORY

Middle

JOHN

Last Name

MALANOSKI

Business Name

GREGORY JOHN MALANOSKI MD

Original Issue Date

01/25/2017

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021