MICHELLE L CRIST Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****15

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

CRIST

Business Name

MICHELLE L CRIST

Original Issue Date

06/30/2010

Effective Date

06/30/2010

Expiration Date

03/31/2012

City

CHESTNUT HILL

State

Zip

02467

County

MASSACHUSETTS

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2012