BEVERLY A BLAKE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020007133

License Status

NOT RENEWED

Business

First Name

BEVERLY A

Last Name

BLAKE

Business Name

BEVERLY A BLAKE

Original Issue Date

03/31/1990

Effective Date

12/01/2021

Expiration Date

09/30/2024

City

WHEATON

State

Zip

60189

Ever Disciplined

LastModifiedDate

02/04/2025