ANNIE T BORDERS-BLACKWELL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037269

License Status

CANCELLED

Business

First Name

ANNIE

Middle

Last Name

BORDERS-BLACKWELL

Suffix

Business Name

ANNIE T BORDERS-BLACKWELL DO

Original Issue Date

06/29/1996

Effective Date

06/29/1996

Expiration Date

03/02/2001

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006