GARY L BLACKMAN OD - Optometrist License in Illinois | # 047932079

GARY L BLACKMAN OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932079

License Status

CANCELLED

Business

N

First Name

GARY

Middle

L

Last Name

BLACKMAN

Suffix

OD

Business Name

GARY L BLACKMAN OD

Original Issue Date

04/19/2006

Effective Date

06/11/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010