BLAKE ANN CLARK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020017863

License Status

ACTIVE

Business

First Name

BLAKE

Middle

ANN

Last Name

CLARK

Business Name

BLAKE ANN CLARK

Original Issue Date

06/01/2023

Effective Date

05/17/2024

Expiration Date

09/30/2027

City

CREAL SPRINGS

State

Zip

62922

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

05/17/2024