KRISTEN A SMITH Optometrist License verification

Business Entity

INACTIVE

License Type

Optometrist

Description

LICENSED OPTOMETRIST

License Number

046010405

License Status

INACTIVE

Business

First Name

KRISTEN

Middle

Last Name

SMITH

Business Name

KRISTEN A SMITH

Original Issue Date

07/21/2010

Effective Date

03/13/2012

Expiration Date

03/31/2014

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

01/09/2014