KORY DANE BLANK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036156954

License Status

ACTIVE

Business

Title

First Name

KORY

Middle

DANE

Last Name

BLANK

Business Name

KORY DANE BLANK MD

Original Issue Date

05/14/2021

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

01/10/2025