BRENT ALAN BLUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

BRENT ALAN

Last Name

BLUE

Suffix

Business Name

BRENT ALAN BLUE MD

Original Issue Date

05/29/1996

Effective Date

05/29/1996

Expiration Date

07/31/2008

City

ARLINGTON HEIGHTS

State

Zip

60005

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020