BRUCE T WAGNER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046006691

License Status

NOT RENEWED

Business

First Name

BRUCE T

Last Name

WAGNER

Business Name

BRUCE T WAGNER

Original Issue Date

08/14/1974

Expiration Date

01/01/1997

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

08/31/2005