RONALD STEPHEN GRANT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

ACTIVE

Business

Title

First Name

RONALD

Middle

STEPHEN

Last Name

GRANT

Business Name

RONALD STEPHEN GRANT MD

Original Issue Date

05/21/2015

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023