DONALD WADE HENDERSON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931696

License Status

CANCELLED

Business

First Name

DONALD

Middle

WADE

Last Name

HENDERSON

Suffix

Business Name

DONALD WADE HENDERSON OD

Original Issue Date

02/15/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010