WAYNE S BLAKE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093241

License Status

ACTIVE

Business

First Name

WAYNE

Middle

Last Name

BLAKE

Suffix

Business Name

WAYNE S BLAKE DO

Original Issue Date

06/19/1996

Effective Date

06/05/2023

Expiration Date

07/31/2026

City

BOCA RATON

State

Zip

33497

Ever Disciplined

LastModifiedDate

06/05/2023