ELIZABETH A GROSSART Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043857

License Status

EXPIRED

Business

First Name

ELIZABETH

Middle

Last Name

GROSSART

Business Name

ELIZABETH A GROSSART

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006