License holder summary

THOMAS LEE BLAKE is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for THOMAS LEE BLAKE is 1806 W MCGALLIARD ROAD, MUNCIE IN 47304. This licensed professional license is not current. The license was granted 04/30/1986 and expired on 03/01/1994.

Indiana

Professional Licensing Agency

THOMAS LEE BLAKE
Controlled Substance Registration - Dentist
License number
12005289B
Date granted
04/30/1986
Date expires
03/01/1994
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
1806 W MCGALLIARD ROAD, MUNCIE IN 47304
indianalicensing.org
ID 22437760
LAST UPDATED 2021-04-13 14:22:48 UTC

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