DANIEL P GILLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

DANIEL P

Last Name

GILLEN

Suffix

Business Name

DANIEL P GILLEN MD

Original Issue Date

06/07/1993

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

BELLEVILLE

State

Zip

62221

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021