STEPHANIE DIANE GAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

DIANE

Last Name

GAN

Business Name

STEPHANIE DIANE GAN MD

Original Issue Date

06/10/2015

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023