CHARLES G GROEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

CHARLES G

Last Name

GROEN

Suffix

Business Name

CHARLES G GROEN MD

Original Issue Date

03/09/1995

Effective Date

08/25/2020

Expiration Date

07/31/2023

City

PERU

State

Zip

61354

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023