JENNIFER J GIBSON CHAMBERS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

Last Name

GIBSON CHAMBERS

Business Name

JENNIFER J GIBSON CHAMBERS

Original Issue Date

04/11/2017

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021