MIRIAM AVIVA BLUMENTHAL MD - Medical Doctor License in Illinois | # 125082912

MIRIAM AVIVA BLUMENTHAL MD

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082912

License Status

ACTIVE

Business

N

Title

MD

First Name

MIRIAM

Middle

AVIVA

Last Name

BLUMENTHAL

Business Name

MIRIAM AVIVA BLUMENTHAL MD

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

06/23/2026

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

03/29/2023