NATHAN ALAN CROUCH OD - Optometrist License in Illinois | # 047934688

NATHAN ALAN CROUCH OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934688

License Status

CANCELLED

Business

N

Title

OD

First Name

NATHAN

Middle

ALAN

Last Name

CROUCH

Business Name

NATHAN ALAN CROUCH OD

Original Issue Date

09/26/2008

Effective Date

09/26/2008

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010