MICHAEL BLASCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Last Name

BLASCO

Business Name

MICHAEL BLASCO MD

Original Issue Date

08/23/2021

Effective Date

08/23/2021

Expiration Date

07/31/2023

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023