DOROTHY E BLANK Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

DOROTHY E

Last Name

BLANK

Business Name

DOROTHY E BLANK

Original Issue Date

06/17/1991

Effective Date

01/12/2015

Expiration Date

01/31/2017

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017