MARK WILLIAM GRAVES Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

MARK

Middle

WILLIAM

Last Name

GRAVES

Business Name

MARK WILLIAM GRAVES

Original Issue Date

05/01/2018

Effective Date

04/23/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/23/2023