NORMAN E BLASE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047037666

License Status

NOT RENEWED

Business

First Name

NORMAN

Middle

Last Name

BLASE

Suffix

Business Name

NORMAN E BLASE OD

Original Issue Date

10/17/1992

Expiration Date

03/31/1994

City

CHICAGO

State

Zip

60641

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005