JEFFREY J BLANCO OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934911

License Status

CANCELLED

Business

First Name

JEFFREY

Middle

Last Name

BLANCO

Suffix

Business Name

JEFFREY J BLANCO OD

Original Issue Date

12/08/2008

Effective Date

12/08/2008

Expiration Date

03/31/2010

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/04/2010