ADAM RUSSELL BLOCK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

ACTIVE

Business

First Name

ADAM

Middle

RUSSELL

Last Name

BLOCK

Suffix

Business Name

ADAM RUSSELL BLOCK DO

Original Issue Date

07/11/2003

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023