ROGER A BLASBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

ROGER A

Last Name

BLASBERG

Suffix

Business Name

ROGER A BLASBERG MD

Original Issue Date

02/29/1988

Effective Date

02/29/1988

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006