BRIAN JAY KORNBLATT 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

BRIAN JAY

Last Name

KORNBLATT

Suffix

Business Name

BRIAN JAY KORNBLATT MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60639

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006