ROBERT HENRY BLACKWELL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058155

License Status

CANCELLED

Business

Title

First Name

ROBERT

Middle

HENRY

Last Name

BLACKWELL

Business Name

ROBERT HENRY BLACKWELL MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2015

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

03/24/2014