JOHN RAYMOND GROLL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

First Name

JOHN RAYMOND

Last Name

GROLL

Suffix

Business Name

JOHN RAYMOND GROLL MD

Original Issue Date

09/26/2023

Effective Date

09/26/2023

Expiration Date

07/31/2026

City

WATERLOO

State

Zip

62298

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2023