ROBERT EDWIN BLAGG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

NOT RENEWED

Business

First Name

ROBERT EDWIN

Last Name

BLAGG

Business Name

ROBERT EDWIN BLAGG

Original Issue Date

01/01/1998

Effective Date

09/10/2015

Expiration Date

09/30/2018

City

CHARLESTON

State

Zip

61920

County

COLES

Ever Disciplined

LastModifiedDate

10/31/2018