ALAN D MONTGOMERY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047058277

License Status

NOT RENEWED

Business

First Name

ALAN

Middle

Last Name

MONTGOMERY

Suffix

Business Name

ALAN D MONTGOMERY OD

Original Issue Date

05/03/1993

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

INA

State

Zip

62846

County

JEFFERSON

Ever Disciplined

LastModifiedDate

09/11/2005