TONYA KAY BOURN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925447

License Status

NOT RENEWED

Business

First Name

TONYA

Middle

KAY

Last Name

BOURN

Suffix

Business Name

TONYA KAY BOURN OD

Original Issue Date

09/24/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/11/2005