TODD LEE GRACEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

TODD LEE

Last Name

GRACEN

Suffix

Business Name

TODD LEE GRACEN MD

Original Issue Date

06/13/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011