BLAKE D ALEXANDER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032542

License Status

EXPIRED

Business

First Name

BLAKE

Middle

Last Name

ALEXANDER

Business Name

BLAKE D ALEXANDER

Original Issue Date

05/15/1995

Effective Date

05/15/1995

Expiration Date

06/30/1998

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006