BRUCE A GROOM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018253

License Status

EXPIRED

Business

First Name

BRUCE A

Last Name

GROOM

Suffix

Business Name

BRUCE A GROOM MD

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

07/01/1988

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006