BENNETT G GRAY IV MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014008

License Status

EXPIRED

Business

First Name

BENNETT G

Last Name

GRAY IV

Suffix

Business Name

BENNETT G GRAY IV MD

Original Issue Date

06/17/1982

Effective Date

06/17/1982

Expiration Date

07/01/1984

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006