Thomas R. Blake

Dentistry Board - Dental Corporation

Indiana  54000510A   Active

This Indiana license is held by Thomas R. Blake. The license is currently active. It was granted on 12/01/1982 and expired on 01/31/2016

LICENSE DETAILS

  • License Number: 54000510A
  • Category: Dental Corporation
  • Status: Active
  • Date Granted: 12/01/1982 (over 42 years ago)
  • Expiry Date: 01/31/2016 (over 9 years ago)

LOCATIONS

A Address

2409 FAIROAK DRIVE, FORT WAYNE IN 46809