GARY L BLACKMAN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933033

License Status

NOT RENEWED

Business

First Name

GARY

Middle

Last Name

BLACKMAN

Suffix

Business Name

GARY L BLACKMAN OD

Original Issue Date

05/17/2007

Effective Date

05/17/2007

Expiration Date

03/31/2008

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

05/02/2008