JIM D BLANKENSHIP MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

CANCELLED

Business

First Name

JIM D

Last Name

BLANKENSHIP

Suffix

Business Name

JIM D BLANKENSHIP MD

Original Issue Date

07/20/1988

Effective Date

07/20/1988

Expiration Date

07/31/2002

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006