JAY R EBBESEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047007326

License Status

NOT RENEWED

Business

First Name

JAY

Middle

Last Name

EBBESEN

Suffix

Business Name

JAY R EBBESEN OD

Original Issue Date

01/02/1987

Expiration Date

03/31/1988

City

ROCK FALLS

State

Zip

61071

County

WHITESIDE

Ever Disciplined

LastModifiedDate

09/01/2005