DAVID JOHN ANDERSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047036938

License Status

CANCELLED

Business

First Name

DAVID

Middle

JOHN

Last Name

ANDERSON

Suffix

Business Name

DAVID JOHN ANDERSON OD

Original Issue Date

06/15/1994

Effective Date

09/29/2008

Expiration Date

03/31/2010

City

BELVIDERE

State

Zip

61008

County

BOONE

Ever Disciplined

LastModifiedDate

05/04/2010