SIDNEY ALLEN BLAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

Title

First Name

SIDNEY

Middle

ALLEN

Last Name

BLAKE

Business Name

SIDNEY ALLEN BLAKE MD

Original Issue Date

04/19/2024

Effective Date

04/19/2024

Expiration Date

07/31/2026

City

ASHEBORO

State

Zip

27205

County

RANDOLPH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026