LISA MARIE GRAY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

CANCELLED

Business

Title

First Name

LISA

Middle

MARIE

Last Name

GRAY

Business Name

LISA MARIE GRAY DO

Original Issue Date

06/12/2012

Effective Date

06/12/2012

Expiration Date

07/31/2014

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014