TONYA KAY BOURN OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047931989

License Status

CANCELLED

Business

First Name

TONYA

Middle

KAY

Last Name

BOURN

Suffix

Business Name

TONYA KAY BOURN OD

Original Issue Date

04/17/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Ever Disciplined

LastModifiedDate

05/04/2010