TRACY LEE GROTRIAN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043143

License Status

EXPIRED

Business

First Name

TRACY

Middle

LEE

Last Name

GROTRIAN

Suffix

Business Name

TRACY LEE GROTRIAN DO

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006