MARY C BLAZEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036081381

License Status

NOT RENEWED

Business

First Name

MARY C

Last Name

BLAZEK

Suffix

Business Name

MARY C BLAZEK MD

Original Issue Date

08/22/1990

Effective Date

08/22/1990

Expiration Date

07/31/2002

City

ANN ARBOR

State

Zip

48104

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/09/2006