JONATHAN GRANT LORD DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066035

License Status

NOT RENEWED

Business

First Name

JONATHAN GRANT

Last Name

LORD

Suffix

Business Name

JONATHAN GRANT LORD DO

Original Issue Date

02/04/1983

Effective Date

02/04/1983

Expiration Date

07/31/1990

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

09/20/2006