JONATHAN EDWARD BLAKE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036133417

License Status

ACTIVE

Business

First Name

JONATHAN

Middle

EDWARD

Last Name

BLAKE

Suffix

Business Name

JONATHAN EDWARD BLAKE DO

Original Issue Date

06/27/2013

Effective Date

08/01/2023

Expiration Date

07/31/2026

City

KANSAS CITY

State

Zip

64113

Ever Disciplined

LastModifiedDate

08/01/2023