SCOTT D POUYAT OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931261

License Status

CANCELLED

Business

First Name

SCOTT

Middle

Last Name

POUYAT

Suffix

Business Name

SCOTT D POUYAT OD

Original Issue Date

07/07/2005

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

LAKE ZURICH

State

Zip

60047

County

LAKE

Ever Disciplined

LastModifiedDate

05/04/2010