AARON JAMES BLAKELY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

AARON JAMES

Last Name

BLAKELY

Suffix

DMD

Business Name

AARON JAMES BLAKELY DMD

Original Issue Date

07/15/1996

Effective Date

07/15/1996

Expiration Date

09/30/2002

City

CLINTON

State

Zip

61727

County

DE WITT

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005