MARK DAVID BLITSTEIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054922

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

DAVID

Last Name

BLITSTEIN

Business Name

MARK DAVID BLITSTEIN MD

Original Issue Date

07/14/1977

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

LAKE

Ever Disciplined

LastModifiedDate

04/28/2023