BLAINE MICHAEL HANNAFIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

CANCELLED

Business

Title

First Name

BLAINE

Middle

MICHAEL

Last Name

HANNAFIN

Business Name

BLAINE MICHAEL HANNAFIN MD

Original Issue Date

12/04/2008

Effective Date

12/04/2008

Expiration Date

07/31/2011

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011