MARK ALLEN GREVIOUS 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

MARK

Middle

ALLEN

Last Name

GREVIOUS

Suffix

Business Name

MARK ALLEN GREVIOUS MD

Original Issue Date

07/07/1999

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023