KATHLEEN LYNNE VIZE OD Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935026

License Status

CANCELLED

Business

First Name

KATHLEEN

Middle

LYNNE

Last Name

VIZE

Suffix

Business Name

KATHLEEN LYNNE VIZE OD

Original Issue Date

01/20/2009

Effective Date

01/20/2009

Expiration Date

03/31/2010

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/04/2010