GRANT DEAN SIEVERTSEN JR MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

GRANT

Middle

DEAN

Last Name

SIEVERTSEN

Suffix

Business Name

GRANT DEAN SIEVERTSEN JR MD

Original Issue Date

01/01/1997

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

HINSDALE

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023