DANIEL ALAN NIELSEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047927407

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

ALAN

Last Name

NIELSEN

Suffix

Business Name

DANIEL ALAN NIELSEN OD

Original Issue Date

09/15/2000

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

ALTAMONT

State

Zip

62411

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

09/11/2005