BLAKE G WELLING MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036081731

License Status

NOT RENEWED

Business

First Name

BLAKE G

Last Name

WELLING

Suffix

Business Name

BLAKE G WELLING MD

Original Issue Date

10/27/1990

Effective Date

10/27/1990

Expiration Date

07/31/1993

City

BROADVIEW

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006