ELIZABETH ANN BLANK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000813

License Status

EXPIRED

Business

First Name

ELIZABETH

Middle

ANN

Last Name

BLANK

Suffix

Business Name

ELIZABETH ANN BLANK MD

Original Issue Date

01/01/2010

Effective Date

01/01/2010

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

04/02/2010