BRIAN KEITH BOUTON OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932870

License Status

CANCELLED

Business

First Name

BRIAN

Middle

KEITH

Last Name

BOUTON

Suffix

Business Name

BRIAN KEITH BOUTON OD

Original Issue Date

02/16/2007

Effective Date

01/10/2008

Expiration Date

03/31/2010

City

CHANNAHON

State

Zip

60410

County

WILL

Ever Disciplined

LastModifiedDate

05/04/2010