PAUL W GROTENHUIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046556

License Status

NOT RENEWED

Business

First Name

PAUL W

Last Name

GROTENHUIS

Suffix

Business Name

PAUL W GROTENHUIS MD

Original Issue Date

10/20/1972

Effective Date

10/20/1972

City

FOREST PARK

State

Zip

60130

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006