DARYL LEE GILDENBLATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

DARYL LEE

Last Name

GILDENBLATT

Suffix

Business Name

DARYL LEE GILDENBLATT MD

Original Issue Date

09/11/1981

Effective Date

09/11/1981

Expiration Date

07/31/1984

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006