PHILLIP WAYNE BLAICH
Physician Assistant Controlled Substance
Illinois 385002131 Not Renewed
This Illinois license was held by PHILLIP WAYNE BLAICH. The license is no longer active. It was granted on 10/07/2008 and expired on 03/01/2014
LICENSE DETAILS
- License Number: 385002131
- Category: PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE
- Status: Not Renewed
- Date Granted: 10/07/2008 (over 16 years ago)
- Expiry Date: 03/01/2014 (about 11 years ago)
LOCATIONS
A Address
Fairfield, IL 62837