WILLIAM V BLAZEK JR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036103622

License Status

NOT RENEWED

Business

First Name

WILLIAM

Middle

Last Name

BLAZEK JR

Business Name

WILLIAM V BLAZEK JR

Original Issue Date

10/06/2000

Effective Date

07/02/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017