PATRICK G GANNON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

PATRICK G

Last Name

GANNON

Suffix

Business Name

PATRICK G GANNON DO

Original Issue Date

09/23/1988

Effective Date

08/17/2023

Expiration Date

07/31/2026

City

MERRIMAC

State

Zip

53561

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/17/2023