JONATHAN TAYLOR GROSSMAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081105

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

TAYLOR

Last Name

GROSSMAN

Business Name

JONATHAN TAYLOR GROSSMAN DO

Original Issue Date

12/05/2022

Effective Date

12/05/2022

Expiration Date

12/04/2024

City

VALPARAISO

State

Zip

46383

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

11/25/2024