GREGORY MARK BLUME MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

GREGORY MARK

Last Name

BLUME

Suffix

Business Name

GREGORY MARK BLUME MD

Original Issue Date

07/28/1997

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/29/2023