GENE JOSEPH BLAKE JR DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015474

License Status

INACTIVE

Business

Title

DDS

First Name

GENE

Middle

JOSEPH

Last Name

BLAKE

Suffix

Business Name

GENE JOSEPH BLAKE JR DDS

Original Issue Date

07/13/1976

Effective Date

08/14/2009

Expiration Date

09/30/2012

City

PALATINE

State

Zip

60067

County

COOK

Ever Disciplined

LastModifiedDate

06/06/2012