MARIA ANTONIA BANAL-BLANCAFLOR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

MARIA ANTONIA

Last Name

BANAL-BLANCAFLOR

Business Name

MARIA ANTONIA BANAL-BLANCAFLOR

Original Issue Date

08/23/1995

Effective Date

08/23/1995

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020