BLAKE WEBSTER DOWELL OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935544

License Status

CANCELLED

Business

First Name

BLAKE

Middle

WEBSTER

Last Name

DOWELL OD

Business Name

BLAKE WEBSTER DOWELL OD

Original Issue Date

07/28/2009

Effective Date

07/28/2009

Expiration Date

03/31/2010

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010