MARISA BETH BLITSTEIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

Title

First Name

MARISA

Middle

BETH

Last Name

BLITSTEIN

Business Name

MARISA BETH BLITSTEIN MD

Original Issue Date

06/11/2014

Effective Date

05/07/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2023