ALICIA NICOLE BLAKLEY DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

Title

DDS

First Name

ALICIA

Middle

NICOLE

Last Name

BLAKLEY

Business Name

ALICIA NICOLE BLAKLEY DDS

Original Issue Date

07/01/2011

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

WAUWATOSA

State

Zip

53226

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2024