SCOTT D POUYAT OD - Optometrist License in Illinois | # 047930876

SCOTT D POUYAT OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930876

License Status

CANCELLED

Business

N

First Name

SCOTT

Middle

D

Last Name

POUYAT

Suffix

OD

Business Name

SCOTT D POUYAT OD

Original Issue Date

01/28/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010