WILLIAM V BLAZEK JR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038509

License Status

EXPIRED

Business

First Name

WILLIAM

Middle

Last Name

BLAZEK JR

Business Name

WILLIAM V BLAZEK JR

Original Issue Date

06/22/1998

Effective Date

06/22/1998

Expiration Date

06/21/2001

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006