SCOTT D POUYAT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926173

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

POUYAT

Suffix

Business Name

SCOTT D POUYAT OD

Original Issue Date

04/16/1999

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

DEERFIELD

State

Zip

60015

County

LAKE

Ever Disciplined

LastModifiedDate

09/11/2005