ANA BACALLAO BLUST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036030646

License Status

NOT RENEWED

Business

First Name

ANA BACALLAO

Last Name

BLUST

Suffix

Business Name

ANA BACALLAO BLUST MD

Original Issue Date

05/17/1951

Effective Date

05/17/1951

City

CHICAGO

State

Zip

60645

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006