RICHARD MARTIN BLAINE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036037030

License Status

INACTIVE

Business

First Name

RICHARD MARTIN

Last Name

BLAINE

Suffix

Business Name

RICHARD MARTIN BLAINE MD

Original Issue Date

12/15/1960

Effective Date

12/15/1960

Expiration Date

07/31/1999

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006