JASON BLAKE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167471

License Status

ACTIVE

Business

Title

First Name

JASON

Last Name

BLAKE

Business Name

JASON BLAKE DO

Original Issue Date

10/24/2023

Effective Date

10/24/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

08/22/2023