NORMAN E BLASE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007666

License Status

NOT RENEWED

Business

First Name

NORMAN

Middle

Last Name

BLASE

Suffix

Business Name

NORMAN E BLASE OD

Original Issue Date

11/11/1988

Expiration Date

03/31/1992

City

ORLAND PARK

State

Zip

60462

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005