SUSAN BLATT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043417

License Status

NOT RENEWED

Business

First Name

SUSAN

Last Name

BLATT

Suffix

Business Name

SUSAN BLATT MD

Original Issue Date

06/30/1970

Effective Date

06/30/1970

City

SALT LAKE

State

Zip

84109

County

UTAH

Ever Disciplined

LastModifiedDate

09/20/2006