BLAIR TANAKA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928662

License Status

NOT RENEWED

Business

First Name

BLAIR

Last Name

TANAKA

Suffix

Business Name

BLAIR TANAKA OD

Original Issue Date

05/01/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

JOLIET

State

Zip

60435

County

WILL

Ever Disciplined

LastModifiedDate

09/11/2005