KURTIS M CARLSON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930770

License Status

NOT RENEWED

Business

First Name

KURTIS M

Last Name

CARLSON

Business Name

KURTIS M CARLSON

Original Issue Date

12/09/2004

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

PITTSFIELD

State

Zip

62363

County

PIKE

Ever Disciplined

LastModifiedDate

05/02/2008