GARY L BLACKMAN OD - Optometrist License in Illinois | # 047931189

GARY L BLACKMAN OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931189

License Status

NOT RENEWED

Business

N

First Name

GARY

Middle

L

Last Name

BLACKMAN

Suffix

OD

Business Name

GARY L BLACKMAN OD

Original Issue Date

05/17/2005

Effective Date

05/17/2005

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006