STANLEY AARON BLOUSTINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053857

License Status

NOT RENEWED

Business

First Name

STANLEY AARON

Last Name

BLOUSTINE

Suffix

Business Name

STANLEY AARON BLOUSTINE MD

Original Issue Date

11/19/1976

Effective Date

11/19/1976

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/20/2006