JAY EDWIN TALLIS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047207271

License Status

NOT RENEWED

Business

First Name

JAY

Middle

EDWIN

Last Name

TALLIS

Suffix

Business Name

JAY EDWIN TALLIS OD

Original Issue Date

04/02/1986

Expiration Date

03/31/1988

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/01/2005