SKYLAR JEAN GROTH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****00

License Status

ACTIVE

Business

First Name

SKYLAR

Middle

JEAN

Last Name

GROTH

Business Name

SKYLAR JEAN GROTH

Original Issue Date

08/19/2024

Effective Date

03/04/2026

Expiration Date

03/01/2028

City

DEERFIELD

State

Zip

60126

County

LAKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/04/2026