ANGEL R BLAZQUEZ Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

First Name

ANGEL R

Last Name

BLAZQUEZ

Business Name

ANGEL R BLAZQUEZ

Original Issue Date

01/20/1993

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

STERLING

State

Zip

61081

County

WHITESIDE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023