MINDY MARIE BLACKFORD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933770

License Status

CANCELLED

Business

First Name

MINDY

Middle

MARIE

Last Name

BLACKFORD

Business Name

MINDY MARIE BLACKFORD

Original Issue Date

02/15/2008

Effective Date

02/15/2008

Expiration Date

03/31/2010

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

05/04/2010