ROBERT R BLAKE Clinical Psychologist License verification

Business Entity

CANCELLED

License Type

Clinical Psychologist

Description

REGISTERED PSYCHOLOGIST

License Number

072001245

License Status

CANCELLED

Business

First Name

ROBERT R

Last Name

BLAKE

Business Name

ROBERT R BLAKE

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

09/04/2005