ANGEL R BLAZQUEZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024603

License Status

EXPIRED

Business

First Name

ANGEL R

Last Name

BLAZQUEZ

Business Name

ANGEL R BLAZQUEZ

Original Issue Date

12/13/1989

Effective Date

12/13/1989

Expiration Date

12/12/1992

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006