GRANVILLE JOSEPH PHILLIPS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107967

License Status

INACTIVE

Business

First Name

GRANVILLE

Middle

JOSEPH

Last Name

PHILLIPS

Suffix

Business Name

GRANVILLE JOSEPH PHILLIPS MD

Original Issue Date

10/07/2002

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

PERRYVILLE

State

Zip

63775

Ever Disciplined

LastModifiedDate

04/17/2008