MARY LOUISE GANNON 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

MARY

Middle

LOUISE

Last Name

GANNON

Suffix

Business Name

MARY LOUISE GANNON MD

Original Issue Date

01/06/2011

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020