DEBRA S BLOG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099047

License Status

NOT RENEWED

Business

First Name

DEBRA

Middle

Last Name

BLOG

Suffix

Business Name

DEBRA S BLOG MD

Original Issue Date

09/17/1998

Effective Date

09/17/1998

Expiration Date

07/31/2002

City

SKOKIE

State

Zip

60076

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006