TODD LEE GRACEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016401

License Status

EXPIRED

Business

First Name

TODD LEE

Last Name

GRACEN

Suffix

Business Name

TODD LEE GRACEN MD

Original Issue Date

09/16/1983

Effective Date

09/16/1983

Expiration Date

09/09/1985

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006