KATHLEEN ACKMAN BLAKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

KATHLEEN

Middle

ACKMAN

Last Name

BLAKE

Suffix

Business Name

KATHLEEN ACKMAN BLAKE MD

Original Issue Date

09/20/1984

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

HINSDALE

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021