GARY ALAN JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

Title

First Name

GARY

Middle

ALAN

Last Name

JOHNSON

Business Name

GARY ALAN JOHNSON MD

Original Issue Date

01/07/2019

Effective Date

06/15/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023