ANDREW W BACKUS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047006702

License Status

CANCELLED

Business

First Name

ANDREW

Middle

Last Name

BACKUS

Suffix

Business Name

ANDREW W BACKUS OD

Original Issue Date

04/19/1976

Expiration Date

01/01/1997

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

09/01/2005