PENGWYNNE BLEVINS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036080252

License Status

NOT RENEWED

Business

First Name

PENGWYNNE

Last Name

BLEVINS

Business Name

PENGWYNNE BLEVINS

Original Issue Date

07/03/1990

Effective Date

07/03/1990

Expiration Date

07/31/2002

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006