BRIAN J BLONIGEN MD - Medical Doctor License in Illinois | # 036129649

BRIAN J BLONIGEN MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129649

License Status

NOT RENEWED

Business

N

Title

MD

First Name

BRIAN

Middle

J

Last Name

BLONIGEN

Business Name

BRIAN J BLONIGEN MD

Original Issue Date

02/22/2012

Effective Date

04/25/2014

Expiration Date

07/31/2017

State

IL

Ever Disciplined

N

LastModifiedDate

11/01/2017