IDA BLAKE
Medical Practice at Secret Ravine Pkwy, Roseville, CA

License number

Florida 35938

Issued Date

May 27, 1999

Effective Date

May 21, 2002

Expiration Date

Aug 31, 2018

Category

Health Care

Type

Clinical Laboratory Personnel

Address

Address

1501 Secret Ravine Pkwy UNIT 1224, Roseville, CA 95661

Phone

(720) 917-4964

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