TONYA KAY BOURN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047925660

License Status

NOT RENEWED

Business

First Name

TONYA

Middle

KAY

Last Name

BOURN

Suffix

Business Name

TONYA KAY BOURN OD

Original Issue Date

05/26/1998

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/11/2005