WAYNE J BLASZAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

WAYNE J

Last Name

BLASZAK

Suffix

Business Name

WAYNE J BLASZAK MD

Original Issue Date

01/07/1992

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

GENEVA

State

Zip

60134

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023