NELSON A BLANCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

NELSON A

Last Name

BLANCO

Suffix

Business Name

NELSON A BLANCO MD

Original Issue Date

06/28/1991

Effective Date

06/19/2014

Expiration Date

07/31/2017

City

ROSELLE

State

Zip

60172

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017