GREGORY S GRANT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030110

License Status

EXPIRED

Business

First Name

GREGORY S

Last Name

GRANT

Suffix

Business Name

GREGORY S GRANT MD

Original Issue Date

06/04/1993

Effective Date

06/04/1993

Expiration Date

06/30/1996

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006