DOUGLAS ALAN BLAZER - Physician Assistant License in Illinois | # 085004130

DOUGLAS ALAN BLAZER

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004130

License Status

ACTIVE

Business

N

First Name

DOUGLAS

Middle

ALAN

Last Name

BLAZER

Business Name

DOUGLAS ALAN BLAZER

Original Issue Date

09/15/2011

Effective Date

01/26/2026

Expiration Date

03/01/2028

State

IL

Ever Disciplined

N

LastModifiedDate

01/26/2026