RICHARD ENRIQUE BLAKE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036058874

License Status

INACTIVE

Business

First Name

RICHARD ENRIQUE

Last Name

BLAKE

Suffix

Business Name

RICHARD ENRIQUE BLAKE MD

Original Issue Date

07/11/1979

Effective Date

07/11/1979

Expiration Date

07/31/1987

City

POTOMAC

State

Zip

20854

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/20/2006