BLAISE J WOLFRUM MD Medical Doctor License verification

BLAISE J WOLFRUM MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079918

License Status

NOT RENEWED

Business

First Name

BLAISE J

Last Name

WOLFRUM

Suffix

Business Name

BLAISE J WOLFRUM MD

Original Issue Date

05/21/1990

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

SCHAUMBURG

State

Zip

60194

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2013004986

Action

Probation

Discipline Start Date

01/16/2026

Discipline Reason

physician and surgeon license to remain indefinitely suspended pending notification of successful passage of SPEX Exam and then placed on indefinitely probation with conditions for a minimum of three years.