KENYON JACOB GRAND DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073950

License Status

EXPIRED

Business

Title

First Name

KENYON

Middle

JACOB

Last Name

GRAND

Business Name

KENYON JACOB GRAND DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

10/11/2022