WILLIAM EDWARD FISH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930255

License Status

CANCELLED

Business

First Name

WILLIAM

Middle

EDWARD

Last Name

FISH

Suffix

Business Name

WILLIAM EDWARD FISH OD

Original Issue Date

06/07/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

05/04/2010