DEAN A GRAVLIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

First Name

DEAN A

Last Name

GRAVLIN

Suffix

Business Name

DEAN A GRAVLIN MD

Original Issue Date

01/01/1997

Effective Date

06/03/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61601

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/03/2023