WILLIAM V BLAZEK JR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

WILLIAM

Middle

Last Name

BLAZEK JR

Business Name

WILLIAM V BLAZEK JR

Original Issue Date

10/20/2000

Effective Date

10/20/2000

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60609

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017