MARK MATTHEW BLOMBERG DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150844

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

MATTHEW

Last Name

BLOMBERG

Business Name

MARK MATTHEW BLOMBERG DO

Original Issue Date

09/25/2019

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

DURAND

State

Zip

61024

Ever Disciplined

LastModifiedDate

04/11/2023