TODD LEE GRACEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

TODD LEE

Last Name

GRACEN

Suffix

Business Name

TODD LEE GRACEN MD

Original Issue Date

10/16/1990

Effective Date

10/16/1990

Expiration Date

07/31/1993

City

BURBANK

State

Zip

60459

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011