DEBRA SMOTHERS-CHAMPLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931188

License Status

NOT RENEWED

Business

Title

First Name

DEBRA

Last Name

SMOTHERS-CHAMPLEY

Business Name

DEBRA SMOTHERS-CHAMPLEY OD

Original Issue Date

05/17/2005

Effective Date

05/17/2005

Expiration Date

03/31/2006

City

NOKOMIS

State

Zip

62075

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

05/11/2006