DANIEL TODD ROSENBLAT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078859

License Status

CANCELLED

Business

Title

First Name

DANIEL

Middle

TODD

Last Name

ROSENBLAT

Business Name

DANIEL TODD ROSENBLAT MD

Original Issue Date

07/01/2021

Effective Date

07/01/2021

Expiration Date

06/30/2024

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/06/2021