TIMOTHY A BLAIN Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099057

License Status

INACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

BLAIN

Business Name

TIMOTHY A BLAIN

Original Issue Date

09/18/1998

Effective Date

05/15/2008

Expiration Date

07/31/2011

City

VENICE

State

Zip

34292

County

FLORIDA

Ever Disciplined

LastModifiedDate

04/07/2011