RYAN B BLANCO DO - Medical Doctor License in Illinois | # 125055126

RYAN B BLANCO DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055126

License Status

CANCELLED

Business

N

Title

DO

First Name

RYAN

Middle

B

Last Name

BLANCO

Business Name

RYAN B BLANCO DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

05/13/2008