CARLOS JAVIER BLANCO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

CARLOS

Middle

JAVIER

Last Name

BLANCO

Business Name

CARLOS JAVIER BLANCO MD

Original Issue Date

11/04/2022

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023