BLAISE KOROSEC MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036032300

License Status

INACTIVE

Business

First Name

BLAISE

Last Name

KOROSEC

Suffix

Business Name

BLAISE KOROSEC MD

Original Issue Date

09/02/1953

Effective Date

09/02/1953

Expiration Date

07/31/2005

City

EAST MOLINE

State

Zip

61244

County

ROCK ISLAND

Ever Disciplined

LastModifiedDate

10/09/2006