MARCIA E BLAKE Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047406808

License Status

NOT RENEWED

Business

First Name

MARCIA E

Last Name

BLAKE

Business Name

MARCIA E BLAKE

Original Issue Date

06/13/1991

Expiration Date

03/31/1996

City

EVERGREEN PARK

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

09/01/2005