DINA REBECCA BLUMENFIELD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049413

License Status

CANCELLED

Business

First Name

DINA

Middle

REBECCA

Last Name

BLUMENFIELD

Suffix

Business Name

DINA REBECCA BLUMENFIELD DO

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006