ANTHONY S BLAZYS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

ANTHONY S

Last Name

BLAZYS

Suffix

Business Name

ANTHONY S BLAZYS MD

Original Issue Date

10/10/1989

Effective Date

10/10/1989

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

09/26/2006