BRIAN J BLONIGEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129649

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

Last Name

BLONIGEN

Business Name

BRIAN J BLONIGEN MD

Original Issue Date

02/22/2012

Effective Date

04/25/2014

Expiration Date

07/31/2017

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/01/2017