KRISTINA LYNN BLAKE Social Worker License verification

Business Entity

ACTIVE

License Type

Social Worker

Description

LICENSED CLINICAL SOCIAL WORKER

License Number

149017084

License Status

ACTIVE

Business

First Name

KRISTINA

Middle

LYNN

Last Name

BLAKE

Business Name

KRISTINA LYNN BLAKE

Original Issue Date

10/30/2014

Effective Date

11/26/2025

Expiration Date

11/30/2027

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Specialty/Qualifier

MASTERS

Ever Disciplined

LastModifiedDate

11/26/2025