MARGA R WASTALU OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008472

License Status

NOT RENEWED

Business

First Name

MARGA R

Last Name

WASTALU

Suffix

Business Name

MARGA R WASTALU OD

Original Issue Date

12/16/1991

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CHINLE

State

Zip

86503

County

ARIZONA

Ever Disciplined

LastModifiedDate

09/11/2005