BENNETT G GRAY IV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

BENNETT G

Last Name

GRAY IV

Suffix

Business Name

BENNETT G GRAY IV MD

Original Issue Date

10/30/2007

Effective Date

03/13/2025

Expiration Date

07/31/2026

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023