J ROBERT FULTS OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931694

License Status

NOT RENEWED

Business

First Name

Middle

ROBERT

Last Name

FULTS

Suffix

Business Name

J ROBERT FULTS OD

Original Issue Date

02/15/2006

Effective Date

02/15/2006

Expiration Date

03/31/2008

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/02/2008