MARLENE L BLAISE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090486

License Status

INACTIVE

Business

First Name

MARLENE L

Last Name

BLAISE

Suffix

Business Name

MARLENE L BLAISE MD

Original Issue Date

04/06/1995

Effective Date

04/06/1995

Expiration Date

07/31/1999

City

ATLANTA

State

Zip

30324

County

GEORGIA

Ever Disciplined

LastModifiedDate

09/20/2006