GRACE SONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108609

License Status

NOT RENEWED

Business

First Name

GRACE

Last Name

SONG

Suffix

Business Name

GRACE SONG MD

Original Issue Date

02/18/2003

Effective Date

02/18/2003

Expiration Date

07/31/2005

City

SHAKER HEIGHTS

State

Zip

44120

County

OHIO

Ever Disciplined

LastModifiedDate

10/09/2006