DALE WESLEY BLAISE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

ACTIVE

Business

First Name

DALE WESLEY

Last Name

BLAISE

Suffix

Business Name

DALE WESLEY BLAISE MD

Original Issue Date

01/20/1983

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2023