GARY L BLACKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047106087

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

BLACKMAN

Suffix

Business Name

GARY L BLACKMAN OD

Original Issue Date

08/30/1994

Effective Date

02/05/2004

Expiration Date

03/31/2006

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

05/11/2006