DAVID JOHN ANDERSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047026938

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

JOHN

Last Name

ANDERSON

Suffix

Business Name

DAVID JOHN ANDERSON OD

Original Issue Date

06/15/1994

Expiration Date

03/31/1996

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005