DOROTHY L BLACKMUN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034195

License Status

EXPIRED

Business

First Name

DOROTHY

Middle

Last Name

BLACKMUN

Business Name

DOROTHY L BLACKMUN

Original Issue Date

05/08/1996

Effective Date

05/08/1996

Expiration Date

06/17/1999

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/22/2006