GENE JOSEPH BLAKE JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

Title

DDS

First Name

GENE

Middle

JOSEPH

Last Name

BLAKE

Suffix

Business Name

GENE JOSEPH BLAKE JR DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

SCHAUMBURG

State

Zip

60194

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009