GRANT W GONZALEZ Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005651

License Status

ACTIVE

Business

First Name

GRANT

Middle

Last Name

GONZALEZ

Business Name

GRANT W GONZALEZ

Original Issue Date

05/18/2015

Effective Date

11/04/2024

Expiration Date

01/31/2027

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/04/2024