BLANE MITCHELL CRANDALL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037652

License Status

CANCELLED

Business

First Name

BLANE

Middle

MITCHELL

Last Name

CRANDALL

Suffix

Business Name

BLANE MITCHELL CRANDALL MD

Original Issue Date

05/13/1998

Effective Date

05/13/1998

Expiration Date

06/23/2001

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006