JENNIFER BLEAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

JENNIFER

Last Name

BLEAK

Suffix

Business Name

JENNIFER BLEAK MD

Original Issue Date

07/20/1993

Effective Date

07/20/1993

Expiration Date

07/31/1996

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020