BLAKE EDWARD MOORES Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018704

License Status

NOT RENEWED

Business

First Name

BLAKE EDWARD

Last Name

MOORES

Business Name

BLAKE EDWARD MOORES

Original Issue Date

08/02/1983

Effective Date

08/02/1983

Expiration Date

09/30/1986

City

OAK FOREST

State

Zip

60452

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005