GLENN L GORDON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

GLENN L

Last Name

GORDON

Suffix

Business Name

GLENN L GORDON MD

Original Issue Date

09/19/1983

Effective Date

08/29/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020