JEFFREY G BLANK Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****09

License Status

ACTIVE

Business

First Name

JEFFREY G

Last Name

BLANK

Business Name

JEFFREY G BLANK

Original Issue Date

06/25/1990

Effective Date

01/07/2025

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025