LUIS ZABALA BLANCO JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

Title

First Name

LUIS

Middle

ZABALA

Last Name

BLANCO

Suffix

Business Name

LUIS ZABALA BLANCO JR MD

Original Issue Date

10/12/2011

Effective Date

10/12/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Ever Disciplined

LastModifiedDate

04/05/2020