DAVID A ROSSELLO OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****54

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

ROSSELLO

Suffix

Business Name

DAVID A ROSSELLO OD

Original Issue Date

08/22/2005

Effective Date

01/18/2006

Expiration Date

03/31/2008

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/02/2008