KEVIN LOUIS GALLOWAY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

LOUIS

Last Name

GALLOWAY

Business Name

KEVIN LOUIS GALLOWAY

Original Issue Date

03/08/2011

Effective Date

06/26/2014

Expiration Date

07/31/2017

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/01/2017