BLAKE DALBERT CHRISTENSEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036135761

License Status

NOT RENEWED

Business

Title

First Name

BLAKE

Middle

DALBERT

Last Name

CHRISTENSEN

Business Name

BLAKE DALBERT CHRISTENSEN DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017