PALMER J BLAKLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

PALMER J

Last Name

BLAKLEY

Suffix

Business Name

PALMER J BLAKLEY MD

Original Issue Date

06/23/1995

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

TINLEY PARK

State

Zip

60477

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021