AMY MEREDITH BLACKBURN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129242

License Status

NOT RENEWED

Business

First Name

AMY

Middle

MEREDITH

Last Name

BLACKBURN

Suffix

Business Name

AMY MEREDITH BLACKBURN MD

Original Issue Date

11/16/2011

Effective Date

11/16/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014