LANCE E GRAVELY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037603

License Status

EXPIRED

Business

First Name

LANCE

Middle

Last Name

GRAVELY

Business Name

LANCE E GRAVELY

Original Issue Date

05/11/1998

Effective Date

05/11/1998

Expiration Date

06/15/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

09/22/2006