DIRK F MASSIE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928620

License Status

NOT RENEWED

Business

First Name

DIRK

Middle

Last Name

MASSIE

Suffix

Business Name

DIRK F MASSIE OD

Original Issue Date

04/29/2002

Effective Date

03/19/2004

Expiration Date

03/31/2006

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Ever Disciplined

LastModifiedDate

05/11/2006