J ROBERT FULTS OD - Optometrist License in Illinois | # 047930583

J ROBERT FULTS OD

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930583

License Status

NOT RENEWED

Business

N

First Name

J

Middle

ROBERT

Last Name

FULTS

Suffix

OD

Business Name

J ROBERT FULTS OD

Original Issue Date

09/14/2004

Effective Date

09/14/2004

Expiration Date

03/31/2006

State

IL

Ever Disciplined

N

LastModifiedDate

05/11/2006