EDMUND L BORMAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047004788

License Status

NOT RENEWED

Business

First Name

EDMUND L

Last Name

BORMAN

Business Name

EDMUND L BORMAN

Original Issue Date

10/24/1986

Expiration Date

03/31/1994

City

ROCKFORD

State

Zip

61111

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005