ANDREW BLACKBURNE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

Title

First Name

ANDREW

Last Name

BLACKBURNE

Business Name

ANDREW BLACKBURNE MD

Original Issue Date

05/06/2021

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

FAIRVIEW HEIGHTS

State

Zip

62208

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023