MARY P GILLAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

First Name

MARY

Middle

Last Name

GILLAM

Suffix

Business Name

MARY P GILLAM MD

Original Issue Date

03/03/1998

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

WILMETTE

State

Zip

60091

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023