ANA BACALLAO BLUST MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

CANCELLED

Business

First Name

ANA BACALLAO

Last Name

BLUST

Suffix

Business Name

ANA BACALLAO BLUST MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

MIAMI

State

Zip

33155

County

FLORIDA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006