BRIDGETTE ANN BLAZEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036113407

License Status

NOT RENEWED

Business

First Name

BRIDGETTE

Middle

ANN

Last Name

BLAZEK

Suffix

Business Name

BRIDGETTE ANN BLAZEK MD

Original Issue Date

04/07/2005

Effective Date

05/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021