J ROBERT FULTS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047206841

License Status

CANCELLED

Business

First Name

Middle

ROBERT

Last Name

FULTS

Suffix

Business Name

J ROBERT FULTS OD

Original Issue Date

02/07/1979

Expiration Date

01/01/1997

City

LINCOLN

State

Zip

62656

County

LOGAN

Ever Disciplined

LastModifiedDate

09/01/2005