THERON A DEROUSSE Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046003188

License Status

INACTIVE

Business

First Name

THERON A

Last Name

DEROUSSE

Business Name

THERON A DEROUSSE

Expiration Date

03/31/1986

City

SPARTA

State

Zip

62286

County

RANDOLPH

Ever Disciplined

LastModifiedDate

08/31/2005