License holder summary

Thomas R. Blake, D.D.S. is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for Thomas R. Blake, D.D.S. is 2409 Fairoak Drive, Fort Wayne IN 46809-2301. This licensed professional license is current. The license was granted 08/18/2003 and expired on 07/05/2015.

Indiana

Professional Licensing Agency

Thomas R. Blake, D.D.S.
Radiology - Radiation Facility Dental
License number
XF900007
Date granted
08/18/2003
Date expires
07/05/2015
Class
Radiology - Radiation Facility Dental
Status
Active
Address
2409 Fairoak Drive, Fort Wayne IN 46809-2301
indianalicensing.org
ID 24932383
LAST UPDATED 2024-03-23 01:51:14 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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