MARK FREDERICK BLUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038269

License Status

NOT RENEWED

Business

First Name

MARK FREDERICK

Last Name

BLUM

Suffix

Business Name

MARK FREDERICK BLUM MD

Original Issue Date

12/20/1962

Effective Date

12/20/1962

City

COLORADO SPRINGS

State

Zip

80902

County

COLORADO

Ever Disciplined

LastModifiedDate

09/20/2006