JOHN A GERGEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

JOHN A

Last Name

GERGEN

Suffix

Business Name

JOHN A GERGEN MD

Original Issue Date

01/20/1987

Effective Date

01/20/1987

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006