ELLEN GAYNOR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

ELLEN

Last Name

GAYNOR

Suffix

Business Name

ELLEN GAYNOR MD

Original Issue Date

01/01/1997

Effective Date

04/24/2017

Expiration Date

09/30/2020

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021