DEBRA S BLOG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

DEBRA

Middle

Last Name

BLOG

Suffix

Business Name

DEBRA S BLOG MD

Original Issue Date

10/28/1998

Effective Date

10/28/1998

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006