BRADLEY STEWART GRANT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****03

License Status

NOT RENEWED

Business

Title

First Name

BRADLEY

Middle

STEWART

Last Name

GRANT

Business Name

BRADLEY STEWART GRANT OD

Original Issue Date

01/10/2013

Effective Date

02/24/2016

Expiration Date

03/31/2018

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2018