BLAKE D ALEXANDER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096788

License Status

NOT RENEWED

Business

First Name

BLAKE

Middle

Last Name

ALEXANDER

Business Name

BLAKE D ALEXANDER

Original Issue Date

10/07/1997

Effective Date

10/07/1997

Expiration Date

07/31/1999

City

RAPID CITY

State

Zip

57702

Ever Disciplined

LastModifiedDate

07/16/2015