GARY L BLACKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932080

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

BLACKMAN

Suffix

Business Name

GARY L BLACKMAN OD

Original Issue Date

04/19/2006

Effective Date

04/19/2006

Expiration Date

03/31/2008

City

VANDALIA

State

Zip

62471

County

FAYETTE

Ever Disciplined

LastModifiedDate

05/02/2008