ADAM BLAINE KRETZER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060402

License Status

CANCELLED

Business

Title

First Name

ADAM

Middle

BLAINE

Last Name

KRETZER

Business Name

ADAM BLAINE KRETZER MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

03/24/2014