JEREMY A BEATTY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931310

License Status

NOT RENEWED

Business

First Name

JEREMY

Middle

Last Name

BEATTY

Suffix

Business Name

JEREMY A BEATTY OD

Original Issue Date

08/01/2005

Effective Date

08/01/2005

Expiration Date

03/31/2006

City

HIGHLAND

State

Zip

62249

County

MADISON

Ever Disciplined

LastModifiedDate

05/11/2006