CHARLES R FAWCETT Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047105287

License Status

NOT RENEWED

Business

First Name

CHARLES R

Last Name

FAWCETT

Business Name

CHARLES R FAWCETT

Original Issue Date

09/16/1972

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

ROCKFORD

State

Zip

61112

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/11/2005