THEODORE E BOGART OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925267

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

Last Name

BOGART

Suffix

Business Name

THEODORE E BOGART OD

Original Issue Date

04/02/1997

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SHELBYVILLE

State

Zip

62565

County

SHELBY

Ever Disciplined

LastModifiedDate

09/11/2005