WALTER GERALD GRAVES MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

Title

First Name

WALTER

Middle

GERALD

Last Name

GRAVES

Business Name

WALTER GERALD GRAVES MD

Original Issue Date

01/29/2018

Effective Date

01/29/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61636

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021