CASEY JAMES CRUMBLISS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931672

License Status

CANCELLED

Business

First Name

CASEY

Middle

JAMES

Last Name

CRUMBLISS

Suffix

Business Name

CASEY JAMES CRUMBLISS OD

Original Issue Date

02/03/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

05/04/2010