LAUREL BLIMA MARK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036063795

License Status

NOT RENEWED

Business

First Name

LAUREL BLIMA

Last Name

MARK

Suffix

Business Name

LAUREL BLIMA MARK MD

Original Issue Date

01/21/1982

Effective Date

01/21/1982

Expiration Date

07/31/1984

City

MADISON

State

Zip

53705

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2013

Case Number

2013007030

Action

Refuse To Renew

Discipline Start Date

10/04/2013

Discipline Reason

after being disciplined by the state of Wisconsin.