BLAINE LYNN ENDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

BLAINE LYNN

Last Name

ENDERSON

Suffix

Business Name

BLAINE LYNN ENDERSON MD

Original Issue Date

08/19/1982

Effective Date

08/19/1982

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006