CRAIG FORREST ROUSE OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****90

License Status

NOT RENEWED

Business

First Name

CRAIG

Middle

FORREST

Last Name

ROUSE

Suffix

Business Name

CRAIG FORREST ROUSE OD

Original Issue Date

07/17/1998

Effective Date

06/04/2004

Expiration Date

03/31/2004

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/11/2005