SAMUEL JOSEPH GRANIERI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

SAMUEL JOSEPH

Last Name

GRANIERI

Suffix

Business Name

SAMUEL JOSEPH GRANIERI MD

Original Issue Date

03/31/1993

Effective Date

03/31/1993

Expiration Date

07/31/1996

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020