MARGO AIDAN GROMOLL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053715

License Status

EXPIRED

Business

Title

First Name

MARGO

Middle

AIDAN

Last Name

GROMOLL

Business Name

MARGO AIDAN GROMOLL MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

PEORIA

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/08/2010