MICHAEL D KORNBLATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

MICHAEL D

Last Name

KORNBLATT

Suffix

Business Name

MICHAEL D KORNBLATT MD

Original Issue Date

12/09/2005

Effective Date

04/26/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60601

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021