DOUGLAS WILLIAM JOHNSON Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932626

License Status

CANCELLED

Business

First Name

DOUGLAS WILLIAM

Last Name

JOHNSON

Business Name

DOUGLAS WILLIAM JOHNSON

Original Issue Date

11/09/2006

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

LITCHFIELD

State

Zip

62056

County

MONTGOMERY

Ever Disciplined

LastModifiedDate

05/04/2010