GRANT DEAN SIEVERTSEN JR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036051989

License Status

ACTIVE

Business

Title

First Name

GRANT

Middle

DEAN

Last Name

SIEVERTSEN

Suffix

Business Name

GRANT DEAN SIEVERTSEN JR MD

Original Issue Date

10/17/1975

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

HINSDALE

State

Zip

60521

County

DUPAGE

Ever Disciplined

LastModifiedDate

06/02/2023