KATHERINE DIRENZO BLATT MD - Medical Doctor License in Illinois | # 125062659

KATHERINE DIRENZO BLATT MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062659

License Status

EXPIRED

Business

N

Title

MD

First Name

KATHERINE

Middle

DIRENZO

Last Name

BLATT

Business Name

KATHERINE DIRENZO BLATT MD

Original Issue Date

06/23/2016

Effective Date

06/23/2016

Expiration Date

06/22/2017

State

IL

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

N

LastModifiedDate

09/19/2017