MEGHAN E BLAKE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044435

License Status

EXPIRED

Business

First Name

MEGHAN

Middle

Last Name

BLAKE

Suffix

Business Name

MEGHAN E BLAKE MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2003

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006