MICHAEL O BLACKSTONE 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

First Name

MICHAEL O

Last Name

BLACKSTONE

Suffix

Business Name

MICHAEL O BLACKSTONE MD

Original Issue Date

01/01/1997

Effective Date

06/24/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60618

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017