KRISTOPHER LEE GLANVILLE Optometrist License verification

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935451

License Status

CANCELLED

Business

First Name

KRISTOPHER

Middle

LEE

Last Name

GLANVILLE

Business Name

KRISTOPHER LEE GLANVILLE

Original Issue Date

06/26/2009

Effective Date

06/26/2009

Expiration Date

03/31/2010

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

05/04/2010