ANNESSA RENEE BLACKMUN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005464

License Status

NOT RENEWED

Business

First Name

ANNESSA

Middle

RENEE

Last Name

BLACKMUN

Suffix

DPM

Business Name

ANNESSA RENEE BLACKMUN DPM

Original Issue Date

12/30/2010

Effective Date

02/01/2017

Expiration Date

01/31/2019

City

NORTHBROOK

State

Zip

60062

County

COOK

Ever Disciplined

LastModifiedDate

02/27/2020

Case Number

2018009131

Action

Suspension

Discipline Start Date

02/24/2020

Discipline Reason

podiatric physician license is indefinitely suspended for a healthcare fraud conviction in violation of 20 ILCS 2105/2105-170.