BRIAN P BLACKWOOD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060193

License Status

EXPIRED

Business

Title

First Name

BRIAN

Middle

Last Name

BLACKWOOD

Business Name

BRIAN P BLACKWOOD MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/25/2018