BLAKE THOMAS WESTRA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028066

License Status

ACTIVE

Business

First Name

BLAKE

Middle

THOMAS

Last Name

WESTRA

Business Name

BLAKE THOMAS WESTRA

Original Issue Date

07/02/2009

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/16/2024