CONNOR R GROTTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080567

License Status

CANCELLED

Business

Title

First Name

CONNOR

Middle

Last Name

GROTTON

Business Name

CONNOR R GROTTON MD

Original Issue Date

06/22/2022

Effective Date

06/22/2022

Expiration Date

06/21/2025

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/07/2022