BLAKE RYAN MOVITZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065505

License Status

EXPIRED

Business

Title

First Name

BLAKE

Middle

RYAN

Last Name

MOVITZ

Business Name

BLAKE RYAN MOVITZ MD

Original Issue Date

06/23/2017

Effective Date

06/23/2017

Expiration Date

06/22/2019

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

10/02/2019