DANIEL JOSEPH GRAVDAHL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134314

License Status

INACTIVE

Business

Title

First Name

DANIEL

Middle

JOSEPH

Last Name

GRAVDAHL

Business Name

DANIEL JOSEPH GRAVDAHL MD

Original Issue Date

12/16/2013

Effective Date

07/02/2014

Expiration Date

07/31/2017

City

PHOENIX

State

Zip

85040

County

ARIZONA

Ever Disciplined

LastModifiedDate

04/12/2017