JASON RICHARD DIEHL OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047933754

License Status

CANCELLED

Business

Title

First Name

JASON

Middle

RICHARD

Last Name

DIEHL

Business Name

JASON RICHARD DIEHL OD

Original Issue Date

02/07/2008

Effective Date

02/07/2008

Expiration Date

03/31/2010

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/04/2010