DAVID LEE GANNON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

ACTIVE

Business

First Name

DAVID

Middle

LEE

Last Name

GANNON

Suffix

Business Name

DAVID LEE GANNON MD

Original Issue Date

01/01/1997

Effective Date

05/31/2023

Expiration Date

07/31/2026

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/31/2023