BLAIR TANAKA OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933068

License Status

CANCELLED

Business

First Name

BLAIR

Last Name

TANAKA

Suffix

Business Name

BLAIR TANAKA OD

Original Issue Date

06/11/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

DIXON

State

Zip

61021

County

LEE

Ever Disciplined

LastModifiedDate

05/04/2010