THERESA ANN HAAS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930781

License Status

NOT RENEWED

Business

First Name

THERESA

Middle

ANN

Last Name

HAAS

Suffix

Business Name

THERESA ANN HAAS OD

Original Issue Date

12/10/2004

Effective Date

08/22/2006

Expiration Date

03/31/2008

City

SPARTA

State

Zip

62286

County

RANDOLPH

Ever Disciplined

LastModifiedDate

05/02/2008