BLAIR W FOREMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

BLAIR

Middle

Last Name

FOREMAN

Suffix

Business Name

BLAIR W FOREMAN MD

Original Issue Date

03/07/2002

Effective Date

03/07/2002

Expiration Date

07/31/2005

City

BETTENDORF

State

Zip

52722

County

SCOTT

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020