WILFREDO A GRANADA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

WILFREDO A

Last Name

GRANADA

Suffix

Business Name

WILFREDO A GRANADA MD

Original Issue Date

01/01/1997

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017