RONALD K GROOTERS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

CANCELLED

Business

First Name

RONALD

Middle

Last Name

GROOTERS

Suffix

Business Name

RONALD K GROOTERS MD

Original Issue Date

10/15/2002

Effective Date

10/15/2002

Expiration Date

07/31/2005

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011