DOUGLAS WILLIAM JOHNSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928781

License Status

NOT RENEWED

Business

First Name

DOUGLAS WILLIAM

Last Name

JOHNSON

Business Name

DOUGLAS WILLIAM JOHNSON

Original Issue Date

06/27/2002

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

09/11/2005