SARAH BETH BLANK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

SARAH

Middle

BETH

Last Name

BLANK

Business Name

SARAH BETH BLANK MD

Original Issue Date

02/26/2019

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023