GUSTAV W GIEBELHAUSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

CANCELLED

Business

First Name

GUSTAV

Middle

Last Name

GIEBELHAUSEN

Suffix

Business Name

GUSTAV W GIEBELHAUSEN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006