BENNETT W NELSON OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932229

License Status

NOT RENEWED

Business

Title

First Name

BENNETT

Middle

Last Name

NELSON

Business Name

BENNETT W NELSON OD

Original Issue Date

05/05/2006

Effective Date

05/05/2006

Expiration Date

03/31/2008

City

PEORIA

State

Zip

61613

County

PEORIA

Ever Disciplined

LastModifiedDate

01/10/2008