ELIZABETH ELLEN GILLES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

ELIZABETH

Middle

ELLEN

Last Name

GILLES

Business Name

ELIZABETH ELLEN GILLES MD

Original Issue Date

01/12/2016

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021