JACKIE LEE GROSKLOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146574

License Status

NOT RENEWED

Business

Title

First Name

JACKIE

Middle

LEE

Last Name

GROSKLOS

Business Name

JACKIE LEE GROSKLOS MD

Original Issue Date

06/26/2018

Effective Date

09/14/2020

Expiration Date

07/31/2023

City

UNIVERSITY CITY

State

Zip

63130

Ever Disciplined

LastModifiedDate

11/30/2023