BLAISE T RONNAU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****07

License Status

NOT RENEWED

Business

First Name

BLAISE T

Last Name

RONNAU

Business Name

BLAISE T RONNAU

Original Issue Date

03/06/2000

Effective Date

03/06/2000

Expiration Date

07/31/2005

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011