DAMIAN W GRIVETTI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

Title

First Name

DAMIAN

Middle

Last Name

GRIVETTI

Business Name

DAMIAN W GRIVETTI MD

Original Issue Date

06/27/2003

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

SPRING VALLEY

State

Zip

61362

County

BUREAU

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023