MARK S GIBSON 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

MARK

Middle

Last Name

GIBSON

Suffix

Business Name

MARK S GIBSON MD

Original Issue Date

03/14/1984

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

WOODSTOCK

State

Zip

60098

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020