LISA BLANKENSHIP MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072304

License Status

CANCELLED

Business

Title

First Name

LISA

Last Name

BLANKENSHIP

Business Name

LISA BLANKENSHIP MD

Original Issue Date

06/20/2018

Effective Date

06/20/2018

Expiration Date

06/19/2021

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/17/2018