WALTER GOODPASTER Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047103514

License Status

NOT RENEWED

Business

First Name

WALTER

Last Name

GOODPASTER

Business Name

WALTER GOODPASTER

Original Issue Date

04/19/1976

Expiration Date

01/01/1997

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/01/2005