TIMOTHY D BUSEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047048141

License Status

NOT RENEWED

Business

Title

First Name

TIMOTHY

Middle

Last Name

BUSEY

Business Name

TIMOTHY D BUSEY OD

Original Issue Date

09/26/1996

Effective Date

06/12/1999

Expiration Date

03/31/1998

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

09/01/2005