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BLAKE, SUSAN LYNN |
| Practice Address: |
SE KANSAS AREA VO-TECH
6TH & ROOSEVELT
COFFEYVILLE KS 67337
Address last updated on 12/23/1999 |
| Phone #: |
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| Fax #: |
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| County: |
NOT OKLAHOMA |
| License: |
842 |
| Dated: |
11/1/1995 |
| Expires: |
10/31/1996 |
|
Temp.
Ltr.
Issued:
|
8/15/1995 |
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Temp.
Ltr.
Expires:
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11/4/1995 |
| License Type: |
Licensed Dietitian |
| Specialty: |
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| Status: |
Inactive |
| Status Class: |
Expired License |
| Restricted to: |
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| CME Year: |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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