KATHLEEN ACKMAN BLAKE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013295

License Status

EXPIRED

Business

First Name

KATHLEEN

Middle

ACKMAN

Last Name

BLAKE

Suffix

Business Name

KATHLEEN ACKMAN BLAKE MD

Original Issue Date

07/14/1981

Effective Date

07/14/1981

Expiration Date

06/22/1983

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006