MANUEL B BLANCO - Medical Doctor License in Illinois | # 125016408

MANUEL B BLANCO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016408

License Status

EXPIRED

Business

N

First Name

MANUEL

Middle

B

Last Name

BLANCO

Business Name

MANUEL B BLANCO

Original Issue Date

09/28/1983

Effective Date

09/28/1983

Expiration Date

10/19/1985

State

IL

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

N

LastModifiedDate

09/22/2006