LEAH JANINE BLAKE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036157733

License Status

NOT RENEWED

Business

Title

First Name

LEAH

Middle

JANINE

Last Name

BLAKE

Business Name

LEAH JANINE BLAKE DO

Original Issue Date

07/18/2021

Effective Date

07/18/2021

Expiration Date

07/31/2023

City

COLORADO SPRINGS

State

Zip

80907

Ever Disciplined

LastModifiedDate

11/30/2023