GARRY DWAINE GRANT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

GARRY

Middle

DWAINE

Last Name

GRANT

Business Name

GARRY DWAINE GRANT

Original Issue Date

11/28/2006

Effective Date

07/24/2014

Expiration Date

07/31/2017

City

HARRISBURG

State

Zip

62946

County

SALINE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/01/2017