BENJAMIN O BLACKMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036031516

License Status

NOT RENEWED

Business

First Name

BENJAMIN O

Last Name

BLACKMAN

Suffix

Business Name

BENJAMIN O BLACKMAN MD

Original Issue Date

08/25/1952

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017