DAVID L ANDERSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928214

License Status

NOT RENEWED

Business

First Name

DAVID L

Last Name

ANDERSON

Business Name

DAVID L ANDERSON

Original Issue Date

10/05/2001

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

09/11/2005