GERALD N BLAIZE OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008459

License Status

INACTIVE

Business

First Name

GERALD N

Last Name

BLAIZE

Suffix

Business Name

GERALD N BLAIZE OD

Original Issue Date

10/18/1991

Expiration Date

03/31/1992

City

ORCHARD LAKE

State

Zip

48324

County

MICHIGAN

Ever Disciplined

LastModifiedDate

08/31/2005