RANDALL I BAUGHMAN Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****75

License Status

NOT RENEWED

Business

First Name

RANDALL I

Last Name

BAUGHMAN

Business Name

RANDALL I BAUGHMAN

Original Issue Date

04/08/1997

Effective Date

05/18/2000

Expiration Date

03/31/2000

City

CENTRALIA

State

Zip

62801

County

CLINTON

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005