KENNETH P GROSS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022018

License Status

EXPIRED

Business

First Name

KENNETH

Middle

Last Name

GROSS

Business Name

KENNETH P GROSS

Original Issue Date

05/05/1988

Effective Date

05/05/1988

Expiration Date

07/01/1991

City

SPRINGFIELD

State

Zip

62974

County

WILLIAMSON

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006