JERRY JONATHAN GIBBONS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

JERRY JONATHAN

Last Name

GIBBONS

Business Name

JERRY JONATHAN GIBBONS

Original Issue Date

06/08/2004

Effective Date

06/08/2004

Expiration Date

07/31/2008

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020