MARK R BLAIS DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004098

License Status

NOT RENEWED

Business

First Name

MARK R

Last Name

BLAIS

Suffix

DPM

Business Name

MARK R BLAIS DPM

Original Issue Date

06/22/1987

Effective Date

06/22/1987

Expiration Date

01/31/1989

City

MIDLOTHIAN

State

Zip

60445

County

COOK

Ever Disciplined

LastModifiedDate

09/25/2006