WILLIAM EDWARD FISH OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925228

License Status

NOT RENEWED

Business

First Name

WILLIAM

Middle

EDWARD

Last Name

FISH

Suffix

Business Name

WILLIAM EDWARD FISH OD

Original Issue Date

02/26/1997

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

PEKIN

State

Zip

61554

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/11/2005