WILLIAM GRADY DAVENPORT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

Title

First Name

WILLIAM

Middle

GRADY

Last Name

DAVENPORT

Business Name

WILLIAM GRADY DAVENPORT MD

Original Issue Date

09/17/2012

Effective Date

05/21/2023

Expiration Date

07/31/2026

City

CHI

State

Zip

60630

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/21/2023