LARS A GENTRY OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931057

License Status

CANCELLED

Business

First Name

LARS

Middle

Last Name

GENTRY

Suffix

Business Name

LARS A GENTRY OD

Original Issue Date

04/14/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

MATTOON

State

Zip

61938

County

COLES

Ever Disciplined

LastModifiedDate

01/10/2008