MICHAEL L GLAVIN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

First Name

MICHAEL L

Last Name

GLAVIN

Business Name

MICHAEL L GLAVIN

Original Issue Date

08/16/1996

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

OTTAWA

State

Zip

61350

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023