GRACE E LOGAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148608

License Status

NOT RENEWED

Business

Title

First Name

GRACE

Middle

Last Name

LOGAN

Business Name

GRACE E LOGAN MD

Original Issue Date

03/15/2019

Effective Date

03/15/2019

Expiration Date

09/30/2020

City

ST. LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

01/14/2021