MARK DAVID BLITSTEIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

DAVID

Last Name

BLITSTEIN

Business Name

MARK DAVID BLITSTEIN MD

Original Issue Date

01/01/1997

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2023