MICHELLE R DURHAM Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932117

License Status

CANCELLED

Business

First Name

MICHELLE

Middle

Last Name

DURHAM

Business Name

MICHELLE R DURHAM

Original Issue Date

04/20/2006

Effective Date

04/20/2006

Expiration Date

03/31/2008

City

QUINCY

State

Zip

62301

County

ADAMS

Ever Disciplined

LastModifiedDate

02/06/2008