JEFFREY DAVID GRIESEMER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

JEFFREY

Middle

DAVID

Last Name

GRIESEMER

Business Name

JEFFREY DAVID GRIESEMER MD

Original Issue Date

08/03/2010

Effective Date

08/03/2010

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011