DOUGLAS HENRY GRANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055649

License Status

NOT RENEWED

Business

First Name

DOUGLAS HENRY

Last Name

GRANT

Suffix

Business Name

DOUGLAS HENRY GRANT MD

Original Issue Date

09/01/1977

Effective Date

09/01/1977

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/20/2006