PHYLLIS C BLECK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

First Name

PHYLLIS C

Last Name

BLECK

Suffix

Business Name

PHYLLIS C BLECK MD

Original Issue Date

01/01/1997

Effective Date

04/14/2011

Expiration Date

07/31/2014

City

BIG ROCK

State

Zip

60511

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020