GUY BLAKEMAN EARLY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016780

License Status

NOT RENEWED

Business

First Name

GUY BLAKEMAN

Last Name

EARLY

Suffix

DDS

Business Name

GUY BLAKEMAN EARLY DDS

Original Issue Date

07/10/1979

Effective Date

07/10/1979

Expiration Date

04/01/1982

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/12/2005