WILLIAM EDWARD FISH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047926389

License Status

CANCELLED

Business

First Name

WILLIAM

Middle

EDWARD

Last Name

FISH

Suffix

Business Name

WILLIAM EDWARD FISH OD

Original Issue Date

09/21/1999

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/04/2010