BLAINE MICHAEL HANNAFIN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122086

License Status

INACTIVE

Business

Title

First Name

BLAINE

Middle

MICHAEL

Last Name

HANNAFIN

Business Name

BLAINE MICHAEL HANNAFIN MD

Original Issue Date

10/17/2008

Effective Date

10/17/2008

Expiration Date

07/31/2011

City

CHANDLER

State

Zip

85224

County

ARIZONA

Ever Disciplined

LastModifiedDate

04/07/2011