Idaho
Division of Occupational and Professional Licenses
ADAM BRYCE BLACKER
Idaho Board Of Optometry - Optometrist W/Tpa
License number
ODP - 100258
Date granted
07/31/2012
Date expires
10/25/2014
Class
Idaho Board Of Optometry - Optometrist W/Tpa
Status
Not Current
Address
GLENDALE AZ 85308
idaholicensing.com
ID 19685303
LAST UPDATED 2024-03-27 14:01:56 UTC
LAST UPDATED 2024-03-27 14:01:56 UTC
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