License holder summary

MAX ALLEN BLACKHAM is a Dental - Dentist Anesthesia Class I Permit licensed to practice in Utah. The address on file for MAX ALLEN BLACKHAM is PLEASANT GROVE, UT 84062. This licensed professional license is not current. The license was granted 01/01/1910 and expired on 05/31/2004.

Utah

Division of Occupational and Professional Licensing

MAX ALLEN BLACKHAM
Dental - Dentist Anesthesia Class I Permit
License number
128987-9921
Date granted
01/01/1910
Date expires
05/31/2004
Class
Dental - Dentist Anesthesia Class I Permit
Status
Expired
Address
PLEASANT GROVE, UT 84062
utahlicensing.org
ID 29716423
LAST UPDATED 2024-03-03 12:24:04 UTC

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