FARRAH NICOLE GASTON DO 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

FARRAH

Middle

NICOLE

Last Name

GASTON

Business Name

FARRAH NICOLE GASTON DO

Original Issue Date

11/01/2024

Effective Date

11/01/2024

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2024