VINCENT MICHAEL BLUM MD - Medical Doctor License in Illinois | # 125049879

VINCENT MICHAEL BLUM MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049879

License Status

EXPIRED

Business

N

First Name

VINCENT

Middle

MICHAEL

Last Name

BLUM

Suffix

MD

Business Name

VINCENT MICHAEL BLUM MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2007

State

IL

Specialty/Qualifier

General Surgery

Ever Disciplined

N

LastModifiedDate

07/03/2007