ROSS W MLSNA OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925266

License Status

NOT RENEWED

Business

First Name

ROSS

Middle

Last Name

MLSNA

Suffix

Business Name

ROSS W MLSNA OD

Original Issue Date

04/02/1997

Effective Date

06/12/1999

Expiration Date

03/31/1998

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

09/01/2005