License holder summary

JAY FORMAN BLANKENSHIP is a Physician - Physician & Surgeon licensed to practice in Utah. The address on file for JAY FORMAN BLANKENSHIP is SALT LAKE CITY, UT 84132. This licensed professional license is not current. The license was granted 10/06/2010 and expired on 01/31/2014.

Utah

Division of Occupational and Professional Licensing

JAY FORMAN BLANKENSHIP
Physician - Physician & Surgeon
License number
7769878-1205
Date granted
10/06/2010
Date expires
01/31/2014
Class
Physician - Physician & Surgeon
Status
Expired
Address
SALT LAKE CITY, UT 84132
utahlicensing.org
ID 29925879
LAST UPDATED 2026-05-01 23:40:53 UTC

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