EDWARD A BLANZY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027498

License Status

EXPIRED

Business

First Name

EDWARD

Middle

Last Name

BLANZY

Business Name

EDWARD A BLANZY

Original Issue Date

08/12/1991

Effective Date

08/12/1991

Expiration Date

08/08/1995

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006