Gerald Robert Blake Dds

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019011459

Status

Inactive

First issued

August 4, 1959

Expired

September 30, 2006

License holder

Gerald Robert Blake Dds

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

09/30/2004

Other Illinois licenses under this name

• IL
  Gerald Robert Blake Dds

  License 31*****12

  Licensed Dentist Controlled Substance (Dental)
  Inactive

  Saint Charles, IL

  Expired Sep 30, 2006

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