BRUCE ALAN DEGROTE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****67

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

ALAN

Last Name

DEGROTE

Business Name

BRUCE ALAN DEGROTE

Original Issue Date

12/22/2005

Effective Date

12/22/2005

Expiration Date

03/01/2008

City

LAGRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

04/23/2008