KEVIN JAY CHILDERS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047037658

License Status

CANCELLED

Business

Title

First Name

KEVIN

Middle

JAY

Last Name

CHILDERS

Business Name

KEVIN JAY CHILDERS OD

Original Issue Date

05/20/1996

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CENTRALIA

State

Zip

62801

County

MARION

Ever Disciplined

LastModifiedDate

05/04/2010