STANLEY A GALL JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

CANCELLED

Business

First Name

STANLEY

Middle

Last Name

GALL

Suffix

JR MD

Business Name

STANLEY A GALL JR MD

Original Issue Date

09/25/1996

Effective Date

09/25/1996

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006