The holder whose full name is BLAKE, THOMAS LEE,come from MUNCIE IN,hold the Dental Anesthesia Permit - GADS license(NO.43000033A) which status is Expired.
| Name | BLAKE, THOMAS LEE |
|---|---|
| License Number | 43000033A |
| License Type | Dental Anesthesia Permit - GADS |
| License Status | Expired |
| City | MUNCIE |
| State | IN |