BENNETT W NELSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046008434

License Status

NOT RENEWED

Business

Title

First Name

BENNETT

Middle

Last Name

NELSON

Business Name

BENNETT W NELSON OD

Original Issue Date

09/21/1991

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010