License holder summary

Diane R Blake is a Board Of Registration In Medicine licensed to practice in Massachusetts. The address on file for Diane R Blake is UMass Memorial Med Ctr/Pediatrics, 55 Lake Avenue North, Worcester 01655. This licensed professional license is current. The license was granted 06/04/1997 and expired on 02/08/2018.

Massachusetts

Division of Professional Licensure

Diane R Blake
Board Of Registration In Medicine
License number
154470
Date granted
06/04/1997
Date expires
02/08/2018
Class
Board Of Registration In Medicine
Status
Active
Address
UMass Memorial Med Ctr/Pediatrics, 55 Lake Avenue North
licensingma.org
ID 41413430
LAST UPDATED 2024-02-10 10:53:45 UTC

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