GERARD BLAISE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014455

License Status

NOT RENEWED

Business

First Name

GERARD

Last Name

BLAISE

Suffix

DDS

Business Name

GERARD BLAISE DDS

Original Issue Date

12/13/1972

Effective Date

09/26/2012

Expiration Date

09/30/2015

City

EAST SAINT LOUIS

State

Zip

62205

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

02/08/2016