BRIAN JAY KORNBLATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060582

License Status

NOT RENEWED

Business

First Name

BRIAN JAY

Last Name

KORNBLATT

Suffix

Business Name

BRIAN JAY KORNBLATT MD

Original Issue Date

07/10/1980

Effective Date

07/10/1980

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006