JARED GROOTWASSINK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077905

License Status

EXPIRED

Business

Title

First Name

JARED

Last Name

GROOTWASSINK

Business Name

JARED GROOTWASSINK MD

Original Issue Date

06/26/2024

Effective Date

06/26/2024

Expiration Date

06/25/2025

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

11/03/2025