JERRY D GRANT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041179

License Status

INACTIVE

Business

First Name

JERRY D

Last Name

GRANT

Suffix

Business Name

JERRY D GRANT MD

Original Issue Date

07/28/1967

Effective Date

07/28/1967

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006