ENRIQUE JULIAN BLANCO MARTINEZ MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080335

License Status

CANCELLED

Business

Title

First Name

ENRIQUE

Middle

JULIAN

Last Name

BLANCO MARTINEZ

Business Name

ENRIQUE JULIAN BLANCO MARTINEZ MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/25/2025