JACK E BALDWIN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047105761

License Status

NOT RENEWED

Business

First Name

JACK E

Last Name

BALDWIN

Business Name

JACK E BALDWIN

Original Issue Date

05/28/1975

Expiration Date

01/01/1997

City

PEORIA

State

Zip

61613

County

PEORIA

Ever Disciplined

LastModifiedDate

09/01/2005