GAYLAN W MOUSHON Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047932906

License Status

NOT RENEWED

Business

First Name

GAYLAN W

Last Name

MOUSHON

Business Name

GAYLAN W MOUSHON

Original Issue Date

03/14/2007

Effective Date

03/14/2007

Expiration Date

03/31/2008

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/02/2008