SIDNEY ALLEN BLAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036169872

License Status

ACTIVE

Business

Title

First Name

SIDNEY

Middle

ALLEN

Last Name

BLAKE

Business Name

SIDNEY ALLEN BLAKE MD

Original Issue Date

04/15/2024

Effective Date

04/15/2024

Expiration Date

07/31/2026

City

ASHEBORO

State

Zip

27205

Ever Disciplined

LastModifiedDate

04/15/2024