LONN J GRANDIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

LONN J

Last Name

GRANDIA

Suffix

Business Name

LONN J GRANDIA MD

Original Issue Date

11/24/1986

Effective Date

04/23/2019

Expiration Date

09/30/2020

City

EDWARDSVILLE

State

Zip

62026

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021