TRACY LEE GROTRIAN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036110788

License Status

ACTIVE

Business

First Name

TRACY

Middle

LEE

Last Name

GROTRIAN

Suffix

Business Name

TRACY LEE GROTRIAN DO

Original Issue Date

02/05/2004

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/14/2023