ANTHONY JAMES POTOCHICK OD Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046009728

License Status

INACTIVE

Business

First Name

ANTHONY

Middle

JAMES

Last Name

POTOCHICK

Suffix

Business Name

ANTHONY JAMES POTOCHICK OD

Original Issue Date

11/05/2004

Effective Date

11/05/2004

Expiration Date

03/31/2006

City

JACKSONVILLE

State

Zip

62207

Ever Disciplined

LastModifiedDate

01/18/2006