CHARLES R FAWCETT Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047405287

License Status

CANCELLED

Business

First Name

CHARLES R

Last Name

FAWCETT

Business Name

CHARLES R FAWCETT

Original Issue Date

07/29/1974

Expiration Date

01/01/1997

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005