J ROBERT FULTS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928054

License Status

NOT RENEWED

Business

First Name

Middle

ROBERT

Last Name

FULTS

Suffix

Business Name

J ROBERT FULTS OD

Original Issue Date

08/15/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

09/11/2005