THEODORE E BOGART OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925628

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

Last Name

BOGART

Suffix

Business Name

THEODORE E BOGART OD

Original Issue Date

05/13/1998

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

TAYLORVILLE

State

Zip

62568

County

CHRISTIAN

Ever Disciplined

LastModifiedDate

09/11/2005