LISA M GRANT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039431

License Status

CANCELLED

Business

First Name

LISA M

Last Name

GRANT

Business Name

LISA M GRANT

Original Issue Date

06/28/1999

Effective Date

06/28/1999

Expiration Date

06/27/2002

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006