License holder summary

Brea N. Blake is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Brea N. Blake is New Albany IN 47150. This licensed professional license is not current. The license was granted 02/25/2014 and expired on 08/25/2014.

Indiana

Professional Licensing Agency

Brea N. Blake
Radiology Provisional Permit
License number
XP505340
Date granted
02/25/2014
Date expires
08/25/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
New Albany IN 47150
indianalicensing.org
ID 29207240
LAST UPDATED 2024-02-05 02:51:32 UTC

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