MATTHEW GARRET BLUM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

CANCELLED

Business

First Name

MATTHEW

Middle

GARRET

Last Name

BLUM

Suffix

Business Name

MATTHEW GARRET BLUM MD

Original Issue Date

08/03/1999

Effective Date

05/22/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011