PHYLLIS C BLECK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036061288

License Status

NOT RENEWED

Business

First Name

PHYLLIS C

Last Name

BLECK

Suffix

Business Name

PHYLLIS C BLECK MD

Original Issue Date

11/21/1980

Effective Date

02/05/2021

Expiration Date

07/31/2023

City

BIG ROCK

State

Zip

60511

County

KANE

Ever Disciplined

LastModifiedDate

11/30/2023