BLAKE DELACROIX MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083981

License Status

ACTIVE

Business

Title

First Name

BLAKE

Last Name

DELACROIX

Business Name

BLAKE DELACROIX MD

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/24/2024