SCOTT D POUYAT OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927230

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

Last Name

POUYAT

Suffix

Business Name

SCOTT D POUYAT OD

Original Issue Date

06/13/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

09/11/2005