KURTIS M CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928078

License Status

NOT RENEWED

Business

First Name

KURTIS M

Last Name

CARLSON

Business Name

KURTIS M CARLSON

Original Issue Date

08/21/2001

Effective Date

04/15/2002

Expiration Date

03/31/2002

City

BARRY

State

Zip

62312

County

PIKE

Ever Disciplined

LastModifiedDate

09/11/2005