DAVID ALLAN JOHNSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930750

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

ALLAN

Last Name

JOHNSON

Suffix

Business Name

DAVID ALLAN JOHNSON OD

Original Issue Date

11/30/2004

Effective Date

11/30/2004

Expiration Date

03/31/2006

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/11/2006