SCOTT HENRY BLOSTICA Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****24

License Status

CANCELLED

Business

First Name

SCOTT

Middle

HENRY

Last Name

BLOSTICA

Business Name

SCOTT HENRY BLOSTICA

Original Issue Date

07/24/1984

Effective Date

07/24/1984

Expiration Date

01/31/2001

City

ORLAND PARK

State

Zip

60467

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006