SCOTT PAUL BLOMBERG OD - Optometrist License in Illinois | # 047932658

SCOTT PAUL BLOMBERG OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932658

License Status

CANCELLED

Business

N

First Name

SCOTT

Middle

PAUL

Last Name

BLOMBERG

Suffix

OD

Business Name

SCOTT PAUL BLOMBERG OD

Original Issue Date

11/15/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010