EDWARD BERNARD BLAIR JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

EDWARD BERNARD

Last Name

BLAIR JR

Suffix

Business Name

EDWARD BERNARD BLAIR JR MD

Original Issue Date

01/01/1997

Effective Date

06/05/2014

Expiration Date

07/31/2017

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017