PATRICK HENRY GIBBONS 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

Title

First Name

PATRICK

Middle

HENRY

Last Name

GIBBONS

Business Name

PATRICK HENRY GIBBONS MD

Original Issue Date

11/03/2015

Effective Date

11/03/2015

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61606

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017