SCOTT HENRY BLOSTICA - Podiatrist License in Illinois | # 016003685

SCOTT HENRY BLOSTICA

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016003685

License Status

INACTIVE

Business

N

First Name

SCOTT

Middle

HENRY

Last Name

BLOSTICA

Business Name

SCOTT HENRY BLOSTICA

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

01/31/2001

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006