JACK E BALDWIN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929137

License Status

NOT RENEWED

Business

First Name

JACK E

Last Name

BALDWIN

Business Name

JACK E BALDWIN

Original Issue Date

11/14/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/11/2005