CHARLES WESLEY GRAHAM III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

CHARLES WESLEY

Last Name

GRAHAM III

Suffix

Business Name

CHARLES WESLEY GRAHAM III MD

Original Issue Date

10/14/2003

Effective Date

10/14/2003

Expiration Date

07/31/2008

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008