GRANT W GONZALEZ Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****15

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

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025