STANLEY AARON BLOUSTINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

STANLEY AARON

Last Name

BLOUSTINE

Suffix

Business Name

STANLEY AARON BLOUSTINE MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006