BRYAN D BLITSTEIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

BRYAN D

Last Name

BLITSTEIN

Suffix

Business Name

BRYAN D BLITSTEIN MD

Original Issue Date

05/02/1995

Effective Date

05/02/1995

Expiration Date

07/31/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006