BLAKE CHILDRESS Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

ACTIVE

Business

First Name

BLAKE

Last Name

CHILDRESS

Business Name

BLAKE CHILDRESS

Original Issue Date

06/14/2025

Effective Date

01/26/2026

Expiration Date

03/01/2028

City

FISHERS

State

Zip

46038

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/26/2026