MIRIAM AVIVA BLUMENTHAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125082912

License Status

ACTIVE

Business

Title

First Name

MIRIAM

Middle

AVIVA

Last Name

BLUMENTHAL

Business Name

MIRIAM AVIVA BLUMENTHAL MD

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

06/23/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/29/2023