ROGER D ROBERTS Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930141

License Status

CANCELLED

Business

First Name

ROGER D

Last Name

ROBERTS

Business Name

ROGER D ROBERTS

Original Issue Date

05/26/2004

Effective Date

03/28/2006

Expiration Date

03/31/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

01/10/2008