KATHERINE MARIE BLAKE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

Title

First Name

KATHERINE

Middle

MARIE

Last Name

BLAKE

Business Name

KATHERINE MARIE BLAKE DO

Original Issue Date

09/02/2014

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023