KELLEY SCHWARTE BAUMHOVER OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930619

License Status

CANCELLED

Business

First Name

KELLEY

Middle

SCHWARTE

Last Name

BAUMHOVER

Suffix

Business Name

KELLEY SCHWARTE BAUMHOVER OD

Original Issue Date

09/28/2004

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

05/04/2010