CLODUALDO ALISANGCO GAMEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

CLODUALDO

Middle

ALISANGCO

Last Name

GAMEZ

Suffix

Business Name

CLODUALDO ALISANGCO GAMEZ MD

Original Issue Date

10/24/2000

Effective Date

10/24/2000

Expiration Date

07/31/2005

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006