BLAKE THOMAS MOSKAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

Title

First Name

BLAKE

Middle

THOMAS

Last Name

MOSKAL

Prefix

Business Name

BLAKE THOMAS MOSKAL MD

Original Issue Date

09/12/2023

Effective Date

09/12/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/12/2023