BLAKE THOMAS MOSKAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036166615

License Status

ACTIVE

Business

Title

First Name

BLAKE

Middle

THOMAS

Last Name

MOSKAL

Prefix

Business Name

BLAKE THOMAS MOSKAL MD

Original Issue Date

08/19/2023

Effective Date

08/19/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

09/12/2023