BLAKE WESLEY SELF Speech-Language Pathologist License verification

Business Entity

ACTIVE

License Type

Speech-Language Pathologist

Description

SPEECH LANGUAGE PATHOLOGIST

License Number

146012447

License Status

ACTIVE

Business

First Name

BLAKE

Middle

WESLEY

Last Name

SELF

Business Name

BLAKE WESLEY SELF

Original Issue Date

10/07/2014

Effective Date

10/10/2025

Expiration Date

10/31/2027

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Ever Disciplined

LastModifiedDate

10/10/2025