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 2026-07-09 03:04:05 UTC
LAST UPDATED 2026-07-09 03:04:05 UTC
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