RAYNA E GRAVATT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

RAYNA

Middle

Last Name

GRAVATT

Business Name

RAYNA E GRAVATT

Original Issue Date

03/13/2007

Effective Date

03/13/2007

Expiration Date

07/31/2008

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008