WAYNE J BLASZAK 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

WAYNE J

Last Name

BLASZAK

Suffix

Business Name

WAYNE J BLASZAK MD

Original Issue Date

07/16/1990

Effective Date

07/16/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020