GLEB GREGORY GENDEL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

GLEB

Middle

GREGORY

Last Name

GENDEL

Business Name

GLEB GREGORY GENDEL DO

Original Issue Date

05/08/2019

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

WOODRIDGE

State

Zip

60517

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023