BLAKE ANTHONY BROOKSHIRE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082599

License Status

ACTIVE

Business

Title

First Name

BLAKE

Middle

ANTHONY

Last Name

BROOKSHIRE

Business Name

BLAKE ANTHONY BROOKSHIRE MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/24/2023