RAYNA E GRAVATT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048713

License Status

EXPIRED

Business

First Name

RAYNA

Middle

Last Name

GRAVATT

Business Name

RAYNA E GRAVATT

Original Issue Date

07/09/2004

Effective Date

07/09/2004

Expiration Date

07/08/2007

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/25/2007