DAVID EBNER BLATT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

ACTIVE

Business

First Name

DAVID EBNER

Last Name

BLATT

Suffix

Business Name

DAVID EBNER BLATT MD

Original Issue Date

01/01/1997

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SAUGATUCK

State

Zip

49453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023