KENNETH R BLAU - Medical Doctor License in Illinois | # 125016274

KENNETH R BLAU

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016274

License Status

EXPIRED

Business

N

First Name

KENNETH

Middle

R

Last Name

BLAU

Business Name

KENNETH R BLAU

Original Issue Date

07/26/1983

Effective Date

07/26/1983

Expiration Date

09/01/1985

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

09/22/2006