JEFFREY ELIOT GROSSMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

ELIOT

Last Name

GROSSMAN

Suffix

Business Name

JEFFREY ELIOT GROSSMAN MD

Original Issue Date

04/01/2010

Effective Date

04/01/2010

Expiration Date

07/31/2011

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/10/2011