MICHAEL JOSEPH BLEND DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

MICHAEL JOSEPH

Last Name

BLEND

Suffix

Business Name

MICHAEL JOSEPH BLEND DO

Original Issue Date

03/11/1992

Effective Date

03/11/1992

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011