ANDREW A GUSTAFSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

Title

First Name

ANDREW

Middle

Last Name

GUSTAFSON

Business Name

ANDREW A GUSTAFSON MD

Original Issue Date

05/03/2023

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2023