HARLAN RAYMOND GILES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

HARLAN

Middle

RAYMOND

Last Name

GILES

Suffix

Business Name

HARLAN RAYMOND GILES MD

Original Issue Date

10/29/2009

Effective Date

05/06/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017