KELLY P GREEN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047038791

License Status

NOT RENEWED

Business

First Name

KELLY P

Last Name

GREEN

Business Name

KELLY P GREEN

Original Issue Date

05/08/1996

Expiration Date

03/31/1998

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

09/01/2005