SCOTT MICHAEL GRUPAS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048326

License Status

CANCELLED

Business

First Name

SCOTT

Middle

MICHAEL

Last Name

GRUPAS

Suffix

Business Name

SCOTT MICHAEL GRUPAS DO

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006