BRIAN KEITH BOUTON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926002

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

KEITH

Last Name

BOUTON

Suffix

Business Name

BRIAN KEITH BOUTON OD

Original Issue Date

12/02/1998

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

09/11/2005