BLASE FREDERICK ROMENCE DC Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038008462

License Status

INACTIVE

Business

First Name

BLASE

Middle

FREDERICK

Last Name

ROMENCE

Suffix

Business Name

BLASE FREDERICK ROMENCE DC

Original Issue Date

05/12/1998

Effective Date

05/12/1998

Expiration Date

07/31/2005

City

SHERMAN

State

Zip

62684

County

SANGAMON

Ever Disciplined

LastModifiedDate

10/07/2009