BLAKE A WEIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036150541

License Status

ACTIVE

Business

Title

First Name

BLAKE

Middle

Last Name

WEIS

Business Name

BLAKE A WEIS MD

Original Issue Date

08/20/2019

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/20/2023