DANIEL R BLIZZARD DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114617

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

BLIZZARD

Suffix

Business Name

DANIEL R BLIZZARD DO

Original Issue Date

09/16/2005

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

HOOPESTON

State

Zip

60942

County

VERMILION

Ever Disciplined

LastModifiedDate

11/06/2008