DANIEL ALAN NIELSEN OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928157

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

ALAN

Last Name

NIELSEN

Suffix

Business Name

DANIEL ALAN NIELSEN OD

Original Issue Date

09/18/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

CENTRALIA

State

Zip

62801

County

MARION

Ever Disciplined

LastModifiedDate

09/11/2005