DOUGLAS NORMAN BLUME MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

NORMAN

Last Name

BLUME

Suffix

Business Name

DOUGLAS NORMAN BLUME MD

Original Issue Date

03/15/2011

Effective Date

07/16/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017