License holder summary

BLAKE N BROG is a Dental - Dentist Anesthesia Class I Permit licensed to practice in Utah. The address on file for BLAKE N BROG is BOUNTIFUL, UT 84010. This licensed professional license is current. The license was granted 07/19/1984 and expired on 05/31/2016.

Utah

Division of Occupational and Professional Licensing

BLAKE N BROG
Dental - Dentist Anesthesia Class I Permit
License number
142188-9921
Date granted
07/19/1984
Date expires
05/31/2016
Class
Dental - Dentist Anesthesia Class I Permit
Status
Active
Address
BOUNTIFUL, UT 84010
utahlicensing.org
ID 29714997
LAST UPDATED 2024-02-13 05:25:51 UTC

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