GARY STUART MILLER 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

Title

First Name

GARY

Middle

STUART

Last Name

MILLER

Business Name

GARY STUART MILLER MD

Original Issue Date

12/14/2011

Effective Date

12/14/2011

Expiration Date

07/31/2014

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020