LARRY WILLIAM BLUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060380

License Status

ACTIVE

Business

First Name

LARRY WILLIAM

Last Name

BLUM

Suffix

Business Name

LARRY WILLIAM BLUM MD

Original Issue Date

06/26/1980

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/27/2023