DIANE GALLO HEATLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134118

License Status

NOT RENEWED

Business

Title

First Name

DIANE

Middle

GALLO

Last Name

HEATLEY

Business Name

DIANE GALLO HEATLEY MD

Original Issue Date

10/29/2013

Effective Date

06/02/2020

Expiration Date

07/31/2023

City

MADISON

State

Zip

53792

County

WISCONSIN

Ever Disciplined

LastModifiedDate

11/30/2023