BLAKE EDWARD MOORES - Dentist License in Illinois | # 019018704

BLAKE EDWARD MOORES

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019018704

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005