NATHAN ALAN CROUCH OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047934688

License Status

CANCELLED

Business

Title

First Name

NATHAN

Middle

ALAN

Last Name

CROUCH

Business Name

NATHAN ALAN CROUCH OD

Original Issue Date

09/26/2008

Effective Date

09/26/2008

Expiration Date

03/31/2010

City

DECATUR

State

Zip

62526

County

MACON

Ever Disciplined

LastModifiedDate

05/04/2010