BRITTANY NOEL BLAISE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

BRITTANY

Middle

NOEL

Last Name

BLAISE

Business Name

BRITTANY NOEL BLAISE MD

Original Issue Date

04/29/2021

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023