LUIS C LEWIS OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932807

License Status

CANCELLED

Business

First Name

LUIS

Middle

Last Name

LEWIS

Suffix

Business Name

LUIS C LEWIS OD

Original Issue Date

01/23/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010