DOUGLAS EDWARD KELLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010053

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

EDWARD

Last Name

KELLEY

Suffix

Business Name

DOUGLAS EDWARD KELLEY OD

Original Issue Date

04/11/2008

Effective Date

04/11/2008

Expiration Date

03/31/2010

City

PEORIA

State

Zip

61615

County

PEORIA

Ever Disciplined

LastModifiedDate

05/04/2010