EDWARD W GANELLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

EDWARD W

Last Name

GANELLEN

Suffix

Business Name

EDWARD W GANELLEN MD

Original Issue Date

02/26/1988

Effective Date

02/26/1988

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006