MARISA BLICKHAN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137001188

License Status

ACTIVE

Business

Title

DMD

First Name

MARISA

Last Name

BLICKHAN

Business Name

MARISA BLICKHAN DMD

Original Issue Date

07/02/2025

Effective Date

07/02/2025

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

Specialty/Qualifier

CONSCIOUS SEDATION - PERMIT A

Ever Disciplined

LastModifiedDate

04/24/2025