MINDY MARIE BLACKFORD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****03

License Status

NOT RENEWED

Business

First Name

MINDY

Middle

MARIE

Last Name

BLACKFORD

Business Name

MINDY MARIE BLACKFORD

Original Issue Date

03/11/2008

Effective Date

03/15/2018

Expiration Date

09/30/2020

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021