JERRY D GRANT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

CANCELLED

Business

First Name

JERRY D

Last Name

GRANT

Suffix

Business Name

JERRY D GRANT MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006