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*****76

License Status

NOT RENEWED

Business

First Name

EDWARD BERNARD

Last Name

BLAIR JR

Suffix

Business Name

EDWARD BERNARD BLAIR JR MD

Original Issue Date

05/21/1986

Effective Date

05/21/1986

Expiration Date

07/31/1993

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

04/11/2017