BLAKE ELLIOT COHEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

ACTIVE

Business

Title

First Name

BLAKE

Middle

ELLIOT

Last Name

COHEN

Business Name

BLAKE ELLIOT COHEN MD

Original Issue Date

03/09/2017

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023