BLAKE DALBERT CHRISTENSEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

Title

First Name

BLAKE

Middle

DALBERT

Last Name

CHRISTENSEN

Business Name

BLAKE DALBERT CHRISTENSEN DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017