BRIAN S GROSSMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

BRIAN S

Last Name

GROSSMAN

Business Name

BRIAN S GROSSMAN

Original Issue Date

06/21/1995

Effective Date

06/21/1995

Expiration Date

07/31/1996

City

SKOKIE

State

Zip

60076

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/26/2006