KAITLIN M BLAKE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020016316

License Status

NOT RENEWED

Business

First Name

KAITLIN

Middle

Last Name

BLAKE

Business Name

KAITLIN M BLAKE

Original Issue Date

08/22/2018

Effective Date

08/22/2018

Expiration Date

01/31/2022

City

ORLAND HILLS

State

Zip

60487

County

COOK

Ever Disciplined

LastModifiedDate

05/09/2022