BLASE N POLITE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

First Name

BLASE

Middle

Last Name

POLITE

Business Name

BLASE N POLITE

Original Issue Date

11/22/2002

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/19/2023