MARLENE GALLEGOS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

CANCELLED

Business

Title

First Name

MARLENE

Last Name

GALLEGOS

Business Name

MARLENE GALLEGOS MD

Original Issue Date

12/29/2011

Effective Date

12/29/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020