GARY L BLACKMAN OD - Optometrist License in Illinois | # 047930938

GARY L BLACKMAN OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930938

License Status

CANCELLED

Business

N

First Name

GARY

Middle

L

Last Name

BLACKMAN

Suffix

OD

Business Name

GARY L BLACKMAN OD

Original Issue Date

03/10/2005

Effective Date

08/18/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010