BARRY F BLITZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025537

License Status

EXPIRED

Business

First Name

BARRY

Middle

Last Name

BLITZ

Business Name

BARRY F BLITZ

Original Issue Date

06/19/1990

Effective Date

06/19/1990

Expiration Date

06/23/1995

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006