BRIDGET M BLAKE PA-C Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007641

License Status

NOT RENEWED

Business

Title

PA-C

First Name

BRIDGET

Middle

Last Name

BLAKE

Business Name

BRIDGET M BLAKE PA-C

Original Issue Date

04/30/2020

Effective Date

04/30/2020

Expiration Date

03/01/2022

City

MINNEAPOLIS

State

Zip

55409

Ever Disciplined

LastModifiedDate

07/27/2022