JAVIER J DIAZ BLANCO 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

JAVIER J DIAZ

Last Name

BLANCO

Suffix

Business Name

JAVIER J DIAZ BLANCO MD

Original Issue Date

06/04/1984

Effective Date

06/04/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006