MARTIN BERNARD BLUMBERG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

CANCELLED

Business

First Name

MARTIN BERNARD

Last Name

BLUMBERG

Suffix

Business Name

MARTIN BERNARD BLUMBERG MD

Original Issue Date

01/01/1997

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011