DAVID JOSEPH GRINDEM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067290

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

JOSEPH

Last Name

GRINDEM

Business Name

DAVID JOSEPH GRINDEM DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/03/2018

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/03/2015