NORMAN E BLASE OD - Optometrist License in Illinois | # 047935395

NORMAN E BLASE OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935395

License Status

CANCELLED

Business

N

First Name

NORMAN

Middle

E

Last Name

BLASE

Suffix

OD

Business Name

NORMAN E BLASE OD

Original Issue Date

06/08/2009

Effective Date

06/08/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010