DAVID KEITH LANDESS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047929440

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

KEITH

Last Name

LANDESS

Suffix

Business Name

DAVID KEITH LANDESS OD

Original Issue Date

04/21/2003

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

FORSYTH

State

Zip

62535

County

MACON

Ever Disciplined

LastModifiedDate

09/11/2005