MYLAUN ELAINE BLACKWELL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125081969

License Status

ACTIVE

Business

Title

First Name

MYLAUN

Middle

ELAINE

Last Name

BLACKWELL

Business Name

MYLAUN ELAINE BLACKWELL MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/13/2023