GARY L BLACKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047076087

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

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

PANA

State

Zip

62557

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

09/11/2005