BRIAN KEITH BOUTON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926001

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

KEITH

Last Name

BOUTON

Suffix

Business Name

BRIAN KEITH BOUTON OD

Original Issue Date

11/30/1998

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

MORRIS

State

Zip

60450

County

GRUNDY

Ever Disciplined

LastModifiedDate

09/11/2005