LT M J BLICK MC USNR Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044464

License Status

NOT RENEWED

Business

First Name

LT M J

Last Name

BLICK

Suffix

MC USNR

Business Name

LT M J BLICK MC USNR

Original Issue Date

07/09/1971

Effective Date

07/09/1971

City

WAUWAUTOSA

State

Zip

53226

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006