IRENE LYNNE BLAKE Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020002538

License Status

INACTIVE

Business

First Name

IRENE LYNNE

Last Name

BLAKE

Business Name

IRENE LYNNE BLAKE

Original Issue Date

07/10/1975

Effective Date

07/10/1975

Expiration Date

09/30/1994

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

10/12/2005