IRA BENNETT KORNBLATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

IRA BENNETT

Last Name

KORNBLATT

Suffix

Business Name

IRA BENNETT KORNBLATT MD

Original Issue Date

12/09/2005

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

MORTON GROVE

State

Zip

60053

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017