JOSHUA ALAN BLOMGREN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050846

License Status

CANCELLED

Business

First Name

JOSHUA

Middle

ALAN

Last Name

BLOMGREN

Suffix

Business Name

JOSHUA ALAN BLOMGREN DO

Original Issue Date

07/01/2006

Effective Date

07/01/2006

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006