BLAIR TANAKA OD - Optometrist License in Illinois | # 047935209

BLAIR TANAKA OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935209

License Status

CANCELLED

Business

N

First Name

BLAIR

Last Name

TANAKA

Suffix

OD

Business Name

BLAIR TANAKA OD

Original Issue Date

04/03/2009

Effective Date

04/03/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010