DAVID A NIELSEN Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046006884

License Status

INACTIVE

Business

First Name

DAVID A

Last Name

NIELSEN

Business Name

DAVID A NIELSEN

Original Issue Date

07/15/1976

Effective Date

03/24/2014

Expiration Date

03/31/2016

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

02/03/2016