LANCE E GRAVELY - Medical Doctor License in Illinois | # 125037603

LANCE E GRAVELY

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037603

License Status

EXPIRED

Business

N

First Name

LANCE

Middle

E

Last Name

GRAVELY

Business Name

LANCE E GRAVELY

Original Issue Date

05/11/1998

Effective Date

05/11/1998

Expiration Date

06/15/2004

State

IL

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

N

LastModifiedDate

09/22/2006