GARY L BLACKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047046087

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

BLACKMAN

Suffix

Business Name

GARY L BLACKMAN OD

Original Issue Date

04/07/1994

Expiration Date

03/31/1996

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/01/2005