GARY ANTHONY WILSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

GARY

Middle

ANTHONY

Last Name

WILSON

Suffix

Business Name

GARY ANTHONY WILSON MD

Original Issue Date

11/12/2010

Effective Date

11/12/2010

Expiration Date

07/31/2011

City

MARION

State

Zip

62959

County

WILLIAMSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011