THEODORE HAROLD GIFFORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

THEODORE HAROLD

Last Name

GIFFORD

Suffix

Business Name

THEODORE HAROLD GIFFORD MD

Original Issue Date

10/22/2002

Effective Date

10/22/2002

Expiration Date

07/31/2008

City

GENEVA

State

Zip

60134

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008