MITCHELL SHERWIN BLIVAISS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

INACTIVE

Business

First Name

MITCHELL SHERWIN

Last Name

BLIVAISS

Suffix

Business Name

MITCHELL SHERWIN BLIVAISS MD

Original Issue Date

01/01/1997

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60203

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/23/2024