EARL R ELLIS Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047004600

License Status

CANCELLED

Business

First Name

EARL R

Last Name

ELLIS

Business Name

EARL R ELLIS

Original Issue Date

09/02/1989

Expiration Date

03/31/1992

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

09/01/2005