The holder whose full name is GROGG, EDWARD PETER,come from URBANA IL,hold the Physician license(NO.01019059A) which status is Expired Non-Renewable.
| Name | GROGG, EDWARD PETER |
|---|---|
| License Number | 01019059A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | URBANA |
| State | IL |