BRUCE T KATZ OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047928940

License Status

CANCELLED

Business

Title

First Name

BRUCE

Middle

Last Name

KATZ

Business Name

BRUCE T KATZ OD

Original Issue Date

09/04/2002

Effective Date

09/17/2003

Expiration Date

03/31/2004

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

09/01/2005