KELLY GROTT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036156733

License Status

NOT RENEWED

Business

Title

First Name

KELLY

Last Name

GROTT

Business Name

KELLY GROTT MD

Original Issue Date

04/27/2021

Effective Date

04/27/2021

Expiration Date

07/31/2023

City

INDIANAPOLIS

State

Zip

46202

Ever Disciplined

LastModifiedDate

11/30/2023