BLAINE AUSTIN MINTON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

Title

First Name

BLAINE

Middle

AUSTIN

Last Name

MINTON

Business Name

BLAINE AUSTIN MINTON DO

Original Issue Date

10/28/2022

Effective Date

04/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/22/2023