RICHARD L GRANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

RICHARD L

Last Name

GRANT

Suffix

Business Name

RICHARD L GRANT MD

Original Issue Date

08/25/1983

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017