LISA BLANKENSHIP MD - Medical Doctor License in Illinois | # 125072304

LISA BLANKENSHIP MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072304

License Status

CANCELLED

Business

N

Title

MD

First Name

LISA

Last Name

BLANKENSHIP

Business Name

LISA BLANKENSHIP MD

Original Issue Date

06/20/2018

Effective Date

06/20/2018

Expiration Date

06/19/2021

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

04/17/2018